DUPLICATE 


''"''      HX0001 3340  ^  ,,).  1  'iiysiciaos  aad  Satl»a& 

A  NARRATIVE 

^  ^  of  the  work  done  in  a  year  by  the 
BOSTON  ASSOCIATION  FOR  THE 
RELIEF  AND  CONTROL  OF  TUBER- 
CUL^IS^  €[  A^  announcement  of 
its  immediate  plans.  ^A  diagram  of  the 
present  resources  in  city  and  state  for 
the  relief  and  control  of  tuberculosis. 
^  An  acknowledgment  and  accounting 
to    those  who   have    provided    the    funds. 


1907 


PRICE  15  CENTS 


4  Joy  Street,  Boston,  Massachusetts 


Digitized  by  the  Internet  Archive 

in  2010  with  funding  from 

Open  Knowledge  Commons 


http://www.archive.org/details/narrativeofworkdOObost 


A  NARRATIVE 


of  the  work  done  in  a  year  by  the 

BOSTON    ASSOCIATION   FOR  THE    RELIEF 

AND    CONTROL    OF    TUBERCULOSIS. 

^  An  announcement  of  its  immediate  plans. 
^  A    diagram    of  the   present    resources 
in   city  and  state   for  the    rehef  and 
control   of  Tuberculosis,  d^  An 
acknowledgment    and    ac- 
counting to  those  who 
have    provided 
the    funds. 


ANNUAL    REPORT,     FOURTH    YEAR 
NOVEMBER   i,  1906,  to  OCTOBER   31,  1907 


The  cross  on  the  cover  is  the 

international  emblem  of  the  campaign  against  tuberculosis. 

Yellow  represents  prophylaxis. 


Price   15  Cents 


4  Joy  Street 
Boston,   Massachusetts 


CONTENTS 

PAGE 

Resources  for  Tuberculous  Persons Frontispiece 

State  Legislation 5 

New  Hospitals 7,  9,  10 

City  Legislation 9 

School  Dental  Clinics  Needed      10 

Relief  and  Control  Nurses 12 

Hospital  and  Sanatorium  Care      14 

Day  Camp  Sanatorium 15 

Where  Cure  Breaks  Down 25 

After  Care 29 

Education 30 

Traveling  Exhibit      30 

Summary  of  Day  Camp  and  Nursing  Work 33 

Treasurer's  Report 34 

Officers  and  Council 35 

Committees  and  Staff 36 

Donations 37 

Objects,  Form  of  Bequest 46 

Membership  Application  Blank     .    .    , 46 


RESOURCES  FOR  TUBERCULOUS  PERSONS 


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State 


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inc/p/ent  Ccues 


Ncu-th(0^tern  Stai(.  f-/oip.{/SO\  -♦ 


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/YoS/3'fa/ fi>r  f^v/>efs 


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Charities 


PriVA  T£ 

l^    Co///i//omefor 

Gooc/  Oomar/i''^f?  //osp. 


7^^'  'Sc/TCieriif/rt 
A/o/jf  GAoit  //o^pt''':-/ 

Car/7 ey  //ospifo/ 


/■re  <^  ^0/77  e  ^ar 
Jt^'.b  /  yjarratoria rcut  farpcofit' 


The  diagram  illustrates  in  rough  proportion  the  resources  for  caring  for  the 
consumptives  of  Boston.  The  central  circle  represents  the  places,  including  private 
physicians'  offices  where  examinations  and  diagnoses  are  made,  and  from  which 
the  patients  are  sent  to  a  suitable  "resource"  when  there  is  a  vacancy. 

The  five  small  inner  circles  represent  the  five  principal  free  clinics. 

The  clinic  for  examination  of  applicants  from  Boston  and  its  vicinity  for  ad- 
mission to  the  Rutland  Sanatorium  (1)  is  represented  by  the  upper  left-hand  inner 
circle,  within  which  are  its  initials.  The  second  (2)  or  next  small  inner  circle  to 
the  right  is  the  Out-Patient  Department  of  the  Boston  Constmiptives  Hospital, 
13  Burroughs  Place.  The  third  (3)  is  the  Boston  Dispensary  on  Beimet  Street. 
The  fourth  (4),  the  Massachusetts  General  Hospital,  on  Grove  Street.  The  fifth  (5), 
the  Out-Patient  Clinic  of  the  Carney  Hospital. 

The  outer  central  circle  represents  the  office  of  the  Association  where  a  central 
registration  and  record  of  all  reported  cases  is  maintained.  A  nurse  is  employed 
to  investigate  and  assist  emergency  cases.  Proper  means  of  disposing  of  sputum, 
literature,  and  information  are  distributed  free. 

With  the  exceptions  above  mentioned  all  of  the  "resources"  may  be  referred  to 
directly.  It  is  noticeable  that  there  is  no  institutional  provision  whatever  for 
children. 


(1)  Is  located  at  Massachusetts  General  Hospital  on  Grove  Street.  It  is  open  on  Wednesdays 
and  Saturdays  from  1.30  to  4. .30  p.m.  Attended  by  a  nurse  from  this  Association  to  care  for  those 
rejected. 

(2)  Controls  admissions  to  the  beds  for  consumptives  in  the  top  or  Municipal  group  of  resources, 
and  to  the  connected  side  groups  —  Holy  Ghost  and  Carney  Hospitals  and  St.  Monica's  Home. 
Also  provides  for  supervised  home  care.  Open  Monday,  Wednesday,  Friday  and  Saturday  (for 
children),  9-12. 

(3)  Provides  supervised  home  care  and  sends  some  cases  direct  to  Rutland  Sanatorium.  Open, 
except  Sunday. 9-11. 

(4)  Out-patient  clinic,  classes,  social  service.     Open,  except  Sunday,  9-10. 

(5)  Open,  except  Sunday,  at  9. 


*'The  conservative  assumes  sickness  as  a  necessary 
fact,  and  his  social  frame  is  a  hospital.  .  .  .  Sickness 
gets  organized  as  ivell  as  health,  the  vice  as  well 
as  the  virtue."  —  Emerson. 

IN  addition  to  a  formal  report  upon  the  scope  and  statistics 
of  its  work  the  public  looks  to  the  Boston  Association  for 
the  Relief  and  Control  of  Tuberculosis  for  news,  for  a  re- 
capitulation of  the  present  situation,  and  for  a  program.  De- 
scription of  the  progress  made  toward  the  relief  and  control  of 
tuberculosis  dm-ing  our  past  year  may  properly  begin  with  an 
outline  of  the  broader  measures  —  those  resulting  from  legis- 
lation passed  for  the  state  and  for  the  City  of  Boston  during 
that  year.  The  Association  agitated  the  need  of  these  measures, 
assisted  the  State  Tuberculosis  Connnission  which  recommended 
some  of  them,  and  was  represented  at  public  and  private  hear- 
ings in  their  advocacy. 

STATE  LEGISLATION 

Massachusetts  General  Court  of  1907  passed  three  acts  of 
main  importance  to  the  common  health.  The  report  of  the 
Tuberculosis  Commission  of  1906  demonstrated  that  our  present 
best  knowledge  of  the  number  and  location  of  tuberculosis 
cases  and  foci  in  Massachusetts  is  not  even  approximate.  Health 
protective  efficiency  requires : 

1  Notification  of  danger  by  whoever  recognizes  it. 

2  Registration  at  a  central  office  of  the  facts  regard- 

ing the  dangerous  thing  or  person. 

3  Examination  of  the  situation  with  a  view  to  erad- 

icating the  danger. 

4  Mechanically  recurrent  attention  until  it  is  erad- 

icated to  prevent  the  danger  slipping  from  notice 
and  control. 
.5   Explanation  of  the  lesson  to  be  learned  by  each 
experience  to  each  person  affected. 


COMPULSORY 
REGIS- 
TRATION 
THE  FIRST 
ACT 


'DANGEROUS 

TO  THE 

PUBLIC 

HEALTH  " 


An  enforced  compulsory  notification  and  registration  law 
is,  therefore,  fundamental  to  intelligent  combat  of  disease. 
This  law  was  passed  at  the  last  session.  It  requires  that  every 
person  who  knows  of  a  case  of  infectious  or  contagious  disease  in 
his  house  or  family  shall  notify  the  selectmen  or  board  of  health 
within  six  hours.  The  householder  must  disinfect  to  the  satis- 
faction of  the  local  board  of  health  whatever  places  or  articles 
have,  in  its  opinion,  been  exposed  to  infection.  The  layman  may 
be  fined  $100  for  failure  to  act  according  to  this  law,  while  the 
attending  physician  who  faUs  to  give  such  notice  is  to  be  fined 
not  less  than  $50  nor  more  than  $200  for  each  offense.  Local 
boards  of  health  or  selectmen  must  in  turn  transmit  the  in- 
formation to  the  state  board  of  health.  With  prompt  and  full 
information  in  hand  from  every  community  it  can  run  a  con- 
tinuous survey  of  the  Commonwealth  and  exercise  statecraft 
where  the  health  defences  are  weakest.  Empowered  by  a 
supplementary  act  of  the  same  session  this  state  board,  on 
August  8,  declared  tuberculosis  to  be  among  the  diseases  ''dan- 
gerous to  the  public  health,"  and  so  to  be  imder  these  provisions. 

The  full  list  of  these  diseases  is  as  follows: 


Actinomycosis 

Anthrax 

Asiatic  Cholera 

Cerebro-Spinal  Meningitis 

Chicken-Pox 

Diphtheria 

Glanders 

Leprosy 

Measles 


Scarlet  Fever 
Smallpox 
Tetanus 
Trichinosis 
Tuberculosis 
Typhoid  Fever 
Typhus  Fever 
Whooping-cough 
Yellow  Fever 


ENFORCE- 
MENT 
OF  LAW 


It  is  not  complimentary  to  our  citizens,  and  especially  to 
that  group  whose  exceptional  educational  advantages  should 
make  them  appreciative  of  the  seriousness  and  immediate 
importance  of  this  law,  to  report  that  there  had  been  no  marked 
change  in  the  first  five  months  after  it  went  into  effect  in  the 
number  of  cases  of  these  diseases  reported.  How  soon  shall 
the  fines  be  invoked? 


The  second  act  established  a  Consumptives  Hospital  Com- 
mission and  provided  for  three  new  State  Sanatoria  of  150  beds 
each  for  advanced  cases  of  tuberculosis.  They  are  to  be  located 
in  the  northeastern  corner  of  the  state,  in  the  southeastern 
corner,  and  in  the  Connecticut  Valley.  The  appropriation 
made  by  the  same  act  of  $100,000  for  site,  buUding  and  equip- 
ment of  each  is  quite  inadequate.  Considermg  present  costs 
and  the  character  of  construction  and  degree  of  comfort  necessary 
for  this  class  of  patients  together  with  the  number  of  beds  to 
be  provided,  it  is  evident  that  the  coming  session  must  augment 
these  allowances.  Important  work  on  the  selection  of  sites 
and  the  plans  has  been  done  by  the  Commission  of  which  Dr. 
Arthur  T.  Cabot  and  Dr.  John  B.  Hawes,  2d,  are  Chairman  and 
Secretary.  The  act  allows  this  Commission  'Ho  establish  out- 
patient departments,"  and  to  "disseminate  knowledge"  as  to 
the  best  methods  of  combating  tuberculosis.  The  amount  of 
publicity  given  by  the  newspapers  to  the  first  health  article 
sent  out  offers  encouragement  for  the  extension  of  this  means 
of  public  education. 

The  third  act  divides  the  State  into  fifteen  health  districts 
and  provides  for  a  "practical  and  discreet"  doctor  of  medicine 
to  be  state  inspector  of  health  in  each.  That  the  state  values 
direct  experience  is  indicated  by  their  term  of  five  years.  The 
inspectors  are  to  gather  information  regarding  the  prevalence 
of  tuberculosis  and  other  diseases  and  influences  dangerous  to 
the  health  of  the  public  m  their  district.  After  consultation 
with  the  State  Board  of  Health,  under  whose  general  direction 
they  work,  and  with  the  local  board  of  health,  they  must  take 
steps  to  abate  such  diseases  and  influences.  They  are  empowered 
to  enforce  the  laws  regarding  light,  ventUation  and  cleanliness 
of  factories,  and  regulate  -  them  in  regard  to  matters  affecting 
the  health  of  the  operatives.  Structural  changes  may  on 
their  recommendation  be  required  by  the  State  police.  They 
are  especially  charged  to  watch  for  Ul  health  or  physical  mifitness 
of  minors  found  in  factories,  and  report  it  to  employer,  parents, 
and  the  State  Board  of  Health.  They  issue  all  licenses  for 
work  to  be  done  in  tenement  houses.  This  last  prerogative 
alone  resulted  immediately  in  discovery  of  many  evil  conditions 
and  the  beginning  of  health  improvement  work. 

7 


EFFICIENT  The  value  of  this  legislation  depends  entirely  on  the  fitness 

INSPECTORS 

of  those  selected  to  carry  out  its  provisions.     Governor  Guild 
was  especially  fortunate  in  the  selection  of  these  health  scouts. 
I  They  are  so  alert  that  they  have  already  found  work  to  do 

beyond  their  individual  strength,  and  it  would  be  economy 
for  the  state  to  give  them  proper  assistance.  With  such  a 
staff  at  large  it  seems  a  safe  prophecy  that  local  health  boards 
will  soon  cease  to  be  mere  policemen  enforcing  fumigation  and 
vaccin^ion  ordinances,  and  will  become  more  efficient  in 
protecting  health  and  developing  vitahty. 

Two  other  laws  of  1907  to  which  attention  should  be  called 
are  those  making  improper  expectoration  in  public  places  an 
offence  punishable  by  a  fine  of  S20  (and  permitting  summary 
arrest  of  such  offenders  without  a  warrant),  and  relievmg  per- 
sons suffering  from  tuberculosis  from  classification  as  paupers 
by  reason  of  any  expenditure  made  for  their  relief  from  this 
disease  by  their  town  or  the  Commonwealth. 


CITY  LEGISLATION 


Boston's  system  of  government  control  of  tuberculosis  has 
been  materiall3^  broadened  and  strengthened  this  year;  and  if 
the  city  can  carry  out  its  present  plans  it  will  become  the  world's 
leader  in  municipal  campaigns  against  tuberculosis.  It  placed 
a  medically  trained  physical  director  over  its  school  gymnasiums 
and  playgrounds  at  the  beginning  of  the  current  school  year, 
and  is  thus  extending  a  new  method  of  unified  municipal  guar- 
dianship over  the  health  of  young  citizens.  Ranking  this  in 
importance  is  the  scheme  of  school  nurses  under  one  superin- 
tendent which  was  instituted  at  the  same  time.  The  physical 
director  and  the  nm^sing  staff  will  discover  many  iUs  in  incipient 
stages  when  simple  remedies  may  be  effectively  applied,  and 
children  having  tuberculosis,  or  other  diseases,  will  be  reported 
and  treated  more  promptly  than  has  hitherto  been  possible. 

The  Boston  Consumptives  Hospital  received  an  additional 
appropriation  late  last  suixuner,  making  a  total  of  $225,000 
with  which  to  build  and  equip  an  ideally  situated  hospital 
of  115  beds  for  advanced  cases.  Work  is  now  being  done  on 
the  site  acquired  in  Mattapan.  Boston  is  taking  the  social  as 
distinguished  from  the  individual  point  of  \iew  and  is  profiting 
by  the  contrasting  experiences  of  Germany  and  Great  Britain 
in  providing  first  for  the  advanced  class  of  tuberculous  patients. 
In  Germany  almost  exclusive  attention  has  been  given  until 
recently  to  incipient  or  sanatorium  cases  with  a  net  result  of  no 
decrease  in  the  general  mortality  from  this  disease  during 
the  last  decade.  Great  Britain,  on  the  other  hand,  has  taken 
care  of  the  hopeless  cases  in  hospitals.  These  cases  sow  the 
infection  wherever  they  are  not  isolated  in  hospitals  or  at  least 
carefully  supervised.  The  death  rate  in  England  from  tubercu- 
losis shows  a  marked  decrease. 

The  Out-Patient  Department  of  the  Boston  Consumptives 
Hospital  was  opened  at  13  Burroughs  Place,  on  September  15. 


WHAT 

BOSTON  HAS 

SECURED 


FIRST  CARE 

FOR 
ADVANCED, 

CASES 


PROFITING 
BY  FOREIGN 
EXPERIENCE 


This  department  maintains  a  registry  of  all  cases  reported  to 
the  Board  of  Health,  provides  throat,  nose  and  chest  clinics, 
and  conducts  classes  for  periodic  re-exanunation,  instruction  and 
treatment  of  all  for  whom  a  regime  of  home  care  seems  desirable. 
A  corps  of  nurses  has  been  provided  to  supervise  such  cases  in 
their  homes  and  to  investigate.  Milk  is  furnished  to  these  cases 
on  the  recommendation  of  the  attending  nurses  where  the  family 
of  the  patient  is  unable  to  provide  such  special  nourishment. 
Both  treatment  and  supervision  are  entirely  free. 

The  city  has  lately  made  an  extraordinary  appropriation  of 
$11,000  for  an  open- ward  shack  sanatorium  to  care  for  from 
forty  to  eighty  advanced  cases,  and  of  $6,000  for  a  permanent 
day  sanatorium  to  accommodate  from  100  to  180  patients.  The 
plan  is  adapted  from  that  of  the  Day  Camp  conducted  by  this 
Association,  which  also  furnished  the  tables  of  costs  and  the 
history  of  success  used  in  the  petition  for  these  appropriations. 

This  summary  of  laws  enacted,  and  of  moneys  given,  marks 
a  parallel  extension  of  the  program  of  the  Association,  since 
each  law  and  each  sum  will  discover  to  us  some  of  those  sick 
or  threatened  persons  who  are  now  outside  the  sphere  of 
health  and  life-saving  aid.  Dr.  R.  W.  Philip  of  Edinburgh,  who 
has  made  in  that  and  other  Scottish  cities  what  are,  as  far  as  we 
know,  the  most  thorough  studies  of  this  subject,  states  that  it 
is  conservative  to  measure  the  number  of  active  cases  in  any 
city  of  Western  civilization  by  the  annual  number  of  deaths 
from  tuberculosis  multiplied  by  ten.  As  there  were  1,100  such 
deaths  in  Boston  last  year  we  may  reckon  the  problem  of  relief 
and  control  on  the  basis  of  11,000  cases — a  number  which  warns 
us  that  every  rational  measure  must  be  taken  to  supplement 
the  safeguards  of  health. 


SCHOOL 
DENTAL 
CLINICS 


Addition  of  school  dental  clinics  to  our  present  school  medical 
and  nursing  work  would  be  a  rational  measure  towards  com- 
pleting the  health  supervision  now  generally  recognized  as 
belonging  to  our  educational  system. 

''Defective  teeth  cause  more  physical  deterioration  than 
does  alcohol,"  said  Dr.  WUliam  Osier  in  a  recent  address  in 
London.  In  their  scholarly  work  "Dental  Hygiene  in  School 
and  Army,"   Doctors  Ernst  Jessen,  Loos,  and  Schlaeger  state 


10 


that  foul  teeth  lead  not  only  to  then-  own  destruction,  but  the 
decaying  tooth  is  an  unsurpassed  culture  medium  for  the  germs 
of  other  diseases.  It  is  believed  that  nearly  all  mouth  and 
neck  gland  tuberculosis  can  be  traced  directly  to  infection 
from  neglected  teeth. 

Through  photographs,  descriptions  and  statistics  gathered  in 
Strassburg  and  elsewhere,  Dr.  Jessen  shows  that  the  average 
child's  mouth  looks  like  the  "burnt  district,"  and  this  diseased 
condition  of  the  teeth  explains  many  of  the  sad  pictures  of  pale 
cheeks,  dull  eyes,  antemia,  and  nervousness,  to  be  seen  in  every 
school.  These  little  unfortunates  cannot  properly  chew  their 
food;  it  is  wasted  and  becomes  a  burden.  They  cannot  even 
learn  to  speak  clearly  and  correctly;  they  become  inattentive, 
fretful  and  disturbing  to  those  about  them  both  night  and  day; 
and  the  new  teeth,  forced  to  prematurity  and  consequent  poor 
quality,  often  become  carious  very  shortly  after  they  appear. 
The  grateful  children  whose  suffering  has  been  stopped  at  such 
clinics  frequently  return  tugging  at  the  hand  of  a  half-abashed 
parent  or  brother,  who  has  not  been  sought  out  by  the  provident 
community,  but  who  is  suffering  because  this  teaching  and  care 
was  not  given  during  his  youth. 

The  New  York  Committee  on  the  Physical  Welfare  of  School 
Children  brought  to  light  the  first  facts  in  regard  to  the  preva- 
lence of  disease  among  American  school  chOdren.  This  Com- 
mittee reports  that  73  per  cent  of  all  school  children  are  badly 
in  need  of  dental  care,  while  less  than  10  per  cent  have  any 
such  care.  Six  months  after  the  original  examination  of  2,200 
pupils,  a  second  examination  of  1,323  of  these  showed  that  but 
two  had  been  given  relief  after  the  Committee  had  called  the 
attention  of  the  parents  to  the  need.  Very  little  of  this  neglect 
was  chargeable  to  poverty,  and  it  seems  fair  to  ascribe  practi- 
cally all  of  it  to  general  ignorance  of  the  grave  importance  of 
dental  hygiene.  Nearly  identical  figures  and  results  are  shown  by 
the  school  dental  examinations  in  Brookline.  The  almost  uni- 
versal prevalence  of  diseased  mouth  conditions,  and  the  proven 
inefficiency  of  mere  information  to  parents  on  the  subject,  should 
be  sufficient  evidence  that  any  immediate  and  practicable  pro- 
gram of  correction  must  have  its  beginning  in  the  educational 
system. 


TUBER- 
CULOSIS 
AND 
THE  TEETH 


11 


THE 

INSPIRATION 

IIS 

GERMAN. 


Professor  Jessen  succeeded,  in  1902,  in  persuading  Strassburg 
to  open  tlie  first  public  school  dental  clinic.  During  the  school 
year  1,543  children  were  examined.  Of  these  childi'en  only  104 
had  perfect  teeth;  92h  per  cent  had  defective  teeth,  and  the 
defectiveness  amounted  to  31  per  cent  of  the  entire  area.  Strass- 
burg now  makes  complete  provision  for  the  dental  hygiene  of 
its  school  children  at  a  cost  of  but  seven  cents  for  each  examina- 
tion and  treatment  and  a  total  expenditure  of  only  $2,000  per 
year.  Thirty-two  German  cities.  New  York,  Brookline,  and 
thirteen  cities  in  other  lands  have  followed  this  lead. 


RELIEF  AND  CONTROL  NURSES 
Good  Samaritanism  might  be  the  title  under  which  to  describe 
the  intricate  ramifications  of  the  daily  service  of  the  Associa- 
tion's trained  nurses.  In  October,  1907,  a  second  nurse  was 
engaged  for  four  hours  a  day  because  the  augmented  number 
of  Day  Sanatorium  patients  had  increased  the  amount  of  work 
beyond  the  capacity  of  one  woman.  She  is  detailed  to  attend  the 
Rutland  Sanatorium  examining  clinic  where  she  interviews 
and  advises  all  applicants.  Those  who  are  rejected  because 
they  have  no  funds  she  places  in  touch  with  charitable  societies 
and  she  advises  those  who  have  been  accepted  regarding  neces- 
sary preparations  and  equipment.  Her  chief  responsibility, 
however,  is  the  disposition  of  the  two-thirds  who  are  rejected 
for  physical  reasons.  Each  one  must  be  visited  in  his  or  her 
home  and  placed,  if  possible,  in  a  hospital  or  other  institution; 
the  bad  housing  conditions  which  the  nurse  finds  must  be 
remedied,  and  the  family  educated  in  hygiene  and  prophylaxis. 
Another  nurse  is  on  duty  daily  from  8.30  to  5.30  o'clock  to 
investigate,  instruct  and  assist  all  cases  referred  to  our  office, 
or  returned  from  the  Rutland  State  Sanatorium.  She  has  made 
1,443  visits  this  year  to  given  addi^esses  and  has  interviewed 
and  helped  1,493  persons.  She  definitely  disposed  of  344  cases 
by  placing  them  in  the  proper  institution  or  arranging  for  other 
adequate  care.  Letters  were  "^Titten  on  behalf  of  patients,  and 
leaflets  were  left  for  the  guidance  of  the  patient  or  his  household 
group  after  personal  instructions  had  been  forgotten.  Through 
this  nurse  and  the  Boston  Dispensary,  over  1,000,000  paper 
napkins  and  bags  were  distributed  as  a  means  to  the  proper 

12 


A  $10.32  Transformation  from  Darkness,  Disorder,  Dirt  and  Discouragement  to 
Sunshine,  Sanitation  and  Simplicity 


Two  rooms,  representing  this  one  before  and  after  our  Nurse  took  the  case, 
are  reproduced  in  the  Traveling  Exhibit 


disposal  of  sputum.  Visits  made  to  mistaken  or  false  addresses 
caused  much  loss  of  valuable  time. 

Our  nurses  regularly  report  cases  and  addresses  to  the  board 
of  health  for  registration  and  fumigation,  and  check  up  its 
reports  against  each  other  and  our  records  so  that  pestilential 
conditions  are  not  allowed  to  slip  through  and  continue.  Over- 
crowding and  illegal  housing  are  reported  for  remedy  and  quaran- 
tine cases  are  pressed.  New  cases  are  reported  to  the  Associated 
Charities  and  the  Boston  Consumptives  Hospital  Out-Patient 
Department.  Duplication  of  work  with  the  visiting  nurses  from 
the  Boston  Dispensary,  the  Boston  Consumptives  Hospital  Out- 
Patient  Department,  or  the  District  Nursing  service,  is  pre- 
vented through  a  weekly  review  of  work  and  frequent  con- 
sultation. 

It  is  not  the  intention  of  this  Association  to  take  charge  of 
any  case  that  falls  within  the  scope  and  resources  of  any  other 
society.  But  we  are  occasionally  forced  to  act  swiftly  upon 
such  cases  to  relieve  acute  distress.  We  do  propose  to  find 
every  gap  in  the  proper  care  of  every  tuberculosis  patient  in 
Boston  and  to  bridge  it  until  it  is  filled.  We  expect  to  pursue 
consistently  our  past  policy  of  utilizing  all  existing  public  and 
private  health  and  charitable  resources  to  their  capacity. 
When  these  fail  we  will  try  to  find  the  nature  of  the  lack  and 
to  devise  a  plan  for  supplying  it  through  an  extension  of  the 
public  functions. 

An  emergency  relief  fund  of  $250  given  last  January  has  paid 
the  board  of  three  people  at  the  state  sanatorium,  the  car  fares 
of  indigent  patients,  and  it  has  clothed  and  fed  some  sick  people 
at  a  sharp  crisis  m  their  affairs.  It  was  also  used  to  pay  the 
salaries  of  a  day  and  a  night  nurse,  and  other  expenses  involved 
in  providing  comfort  and  care  through  several  weeks  for  a  brother 
and  sister  dying  at  the  ages  of  twenty-one  and  twenty-three. 
They  were  discovered  in  the  last  stages  of  phthisis  in  a  little 
home  they  had  striven  with  increasing  difficulty  to  maintain 
for  each  other  after  the  death  of  their  parents  from  the  same 
disease.  Their  devotion  to  each  other  was  so  deep,  their  fear 
of  separation  so  great  that  no  one  would  subject  them  to  the 
misery  of  parting  at  a  hospital  door.  They  died  peacefully  on 
the  same  dav. 


SCOPE  OF 
RELIEF 


EASING 
DEATH 


13 


30  NEW 

HOSPITAL 

BEDS 


52  BEDS 
SAVED 


TUBER- 
CULOUS 
CHILDREN 


CLINICAL 
DISTRICTS 


HOSPITAL  AND  SANATORIUM  CARE 

The  generosity  of  one  man  enabled  our  Association  to  in- 
crease by  thirty  beds  the  meagre  hospital  facOities  for  advanced 
cases  in  and  near  Boston,  through  fitting  out  a  ward  in  the 
Holy  Ghost  Hospital.  The  trustees  of  the  Boston  Consump- 
tives Hospital  had  been  given  authority  by  the  General  Court 
of  1906,  to  hire  100  beds  in  private  hospitals,  pending  the 
erection  of  its  own  institution,  at  five  dollars  per  week.  At 
that  rate  the  hospital  would  have  lost  $3.00  per  week  on  each 
patient  taken.  In  order  to  make  these  beds  immediately 
available,  the  Association  offered  to  pay  the  difference  until 
the  law  could  be  changed.  The  offer  was  accepted,  the  beds 
were  filled  with  some  of  the  worst  suffering  and  most  dangerous 
cases,  and  in  1907  the  law  was  changed  so  that  the  city  could 
pay  the  full  sum.  This  piece  of  efficient  gap  filling  cost 
$3,539.88. 

Fifty-two  beds  had  long  been  provided  for  Boston  cases  in 
the  specially  constructed  tuberculosis  ward  of  the  Long  Island 
Hospital.  It  was  learned  late  in  the  year  that  the  trustees  of  this 
hospital  were  preparing  to  close  this  ward,  whereupon  such  a 
presentation  of  the  situation  was  made  as  will  probably  continue 
to  guarantee  the  rights  of  the  sick  as  long  as  it  is  necessary. 

We  are  encouraged  to  believe  that  provision  will  be  made  for 
children  suffering  with  tuberculosis  in  its  later  stages  at  one, 
and  perhaps  aU,  of  the  new  state  sanatoria. 

Our  Committee  on  Tuberculous  Children  and  the  Conmiittee 
on  Relief  and  Control,  through  our  own  nurses  and  the  co- 
operation of  the  Associated  Charities  and  the  children's  societies, 
have  secured,  since  January,  1907,  the  examination  of  1,250 
members  of  families  in  which  there  was  knovm  to  be  a  case  of 
the  white  plague.  This  precautionary  measure  revealed  that 
about  33  per  cent  of  the  children  of  this  group  were  tuberculous 
and  that  an  additional  17  per  cent  were  pre-tuberculous  —  that 
is,  weak  and  anaemic  and  less  than  normally  able  to  withstand 
infection  when  exposed  to  it.  The  Committee  on  Tuberculous 
Children  has  worked  out  and  secured  adoption  of  a  scheme  of 
clinical  districts.  Exposed  children  or  others  discovered  through 
its  efforts  are  to  be  taken  for  examination  and  subsequent 
observation  to  the  clinic  within  the  district  where  they  live. 


14 


It  has  made  a  great  effort  to  secure  adequate  care  for  each  class 
of  children's  cases.  If  public  relief  fails  today  under  the  burden 
of  thousands  and  thousands  of  consumptives  whom  it  cannot 
help,  it  is  because  no  remedy  is  applied  before  the  evil  has 
passed  its  hidden  development.  In  France  a  movement  has 
grown  up  under  the  leadership  of  the  late  Professor  Grancher 
for  providing  country  homes  and  schools  for  all  of  these  pre- 
tuberculous  children.  Throughout  Germany  and  in  other  parts  of 
Europe  such  children  are  sent  to  Schools-in-the-woods.  Except 
during  storms  all  of  the  life  is  out  of  doors.  Thus  society  dis- 
places weakling  by  sturdy  youth.  Possibly  our  camp  equipment, 
released  as  it  will  be  by  the  city's  new  provision,  can  be  adapted 
to  demonstration  of  the  value  of  these  ideas  in  America. 


GRANCHER'S 
WORK 


WALDSCHULE 


THE  DAY  CAMP  SANATORIUM  AT  MATTAPAN 

Obvious  as  are  the  difficulties  of  caring  for  sick  people  where 
one  has  charge  and  control  over  them  for  less  than  half  of  the 
time,  during  the  remainder  of  which  they  are  at  home,  yet  the 
results  to  the  community  may  eventually  be  as  great,  if  not 
greater,  than  by  the  isolation  methods  of  hospitals  and  sana- 
toria. There  is  a  growing  feeling  among  physicians  and 
social  workers  that  except  for  acute  and  dangerously  infectious 
diseases  there  must  be  more  treatment  in  the  home,  and  recog- 
nition of  the  economic  impossibility  of  more  general  dependence 
on  hospitals;  and  since  Boston,  for  example,  is  now  straining  its 
resources  to  build  a  hospital  for  115  patients,  it  is  clear  that 
we  must  look  for  complementary  methods  of  caring  for  the 
11,000  of  its  residents  who  by  conservative  estimate  are  now 
suffering  from  tuberculosis. 

A  distinctive  virtue  of  day  and  home  care  of  the  sick  is  that 
it  recognizes  the  family  relationship.  To  make  the  family  the 
unit  of  treatment  is,  it  seems,  especially  desirable  in  dealing 
with  a  scourge  so  general  and  insidious.  The  elements  of 
tuberculosis  treatment  are  as  valuable  for  heart  and  nerve 
trouble  as  for  the  limgs,  for  they  consist  of  hygiene  rather  than  of 
medication,  are  so  simple  and  rational  that  mistake  in  their 
apphcation  is  difficult. 

The  Day  Camp  Sanatorium  estabhshed  by  the  Boston  Asso- 
ciation for  the  Relief  and  Control  of  Tuberculosis  three  years 


NOT  AN 

EXPEDIENT 

BUT  A  NEW 

KIND  OF 

RESOURCE 


THE  FAMILY 
PRESERVED 


THREE 
YEARS IH 
AMERICA 


15 


\ 


SALEM    CAMP 

HOUSE  OF 
THE  GOOD 
SAMARITAN 


(DAY  CARE 

ON  A 

FERRY    BOAT 


ANEW 
LOCATION 


HIGH 
ALTITUDE 

NOT 
NECESSARY 


ago,  after  German  precedents,  has  justified  the  boldness  of  its 
promoters  in  attempting  to  cm^e  on  the  sea  level  in  a  trying 
climate  with  crude  equipment  and  with  home  complications  — 
and  compensations  —  as  a  background.  It  has  proven  practi- 
cable, economical,  and  educative.  An  extended  report  of  its 
methods,  costs,  and  results  is  here  presented  in  the  earnest  hope 
that  it  may  lead  to  a  rapid  extension  of  work  on  similar  lines. 
The  first  outgrowth  of  our  experiment  was  the  Camp  connected 
wdth  the  Salem  General  Hospital,  the  second  is  that  of  the 
House  of  the  Good  Samaritan  Hospital  in  Brookline,  and  the 
third  is  in  New  York.  After  looking  in  vain  for  a  suitable  plot 
of  ground  the  New  York  Tuberculosis  Committee  borrowed  a 
retired  municipal  ferry-boat  which  was  tied  to  the  end  of  a 
pier  where  it  was  swept  by  the  harbor  breezes.  The  House  of 
the  Good  Samaritan  Camp  is  run  in  conjunction  with  the  hos- 
pital and  illustrates  what  imagination  can  do  by  way  of  in- 
creasing the  productiveness  of  hospital  investment.  Twenty- 
five  patients,  half  as  many  as  are  cared  for  in  the  wards,  are 
sheltered  in  the  yard  under  the  lee  of  the  building  the  year 
around.  This  is  done  practically  without  extra  cost  of  equip- 
ment and  at  a  daily  average  cost  of  thirty-two  cents  per  patient 
per  day.  The  Salem  Camp  has  thus  far  been  maintained 
through  the  summer  months  only,  and  is  not  strictly  for  day 
care,  but  like  the  others  has  been  proven  a  notable  success. 

After  two  successful  seasons  on  Parker  Hill,  in  the  heart  of 
Boston,  the  "Day  Camp"  was  removed  this  year  to  the  beauti- 
ful Conness  Estate  in  Mattapan.  The  trustees  of  the  Consump- 
tives Hospital  of  the  City  of  Boston  had  recently  acquired 
these  fifty-eight  acres  as  a  site  for  their  institution.  Not  only 
did  they  very  graciously  consent  to  our  use  of  a  portion  of  the 
land  but  they  put  in  the  sanitary  system  and  did  everything 
else  in  their  power  to  assist  and  encourage  us.  The  tract  lies 
within  the  city  limits  and  consists  of  a  southerly  slope  in  two 
terraces  picturesquely  divided  by  an  escarpment  of  huge 
masses  and  boulders  of  pudding-stone.  The  soil  is  light  and 
provided  with  an  exceptional  drainage  system.  Within  sight 
is  the  Neponset  River.  Our  experience  has  been  entirely 
satisfactory  and  offers  a  partial  confirmation  of  the  judgment 
used  in  selecting  the  property  for  this  purpose.     There  has  been 

16 


The  office  and  examining  room,  rest  tents  and  dining  tent  of  the  Day  Camp  Sanatorium 


The  Living  Christmas  Tree  of  the  Day  Camp  patients 


no  notable  dampness,  we  were  cooler  than  other  parts  of  the 
city  in  summer  and  the  natm^al  shelter  of  the  spot  has  already 
proved  welcome  this  winter.  We  hoped  that  the  Association's 
demonstration  of  the  practicability  and  efficiency  of  the  day 
sanatorium  idea  under  American  conditions  would  induce  the 
city's  trustees  to  accept  it  as  part  of  their  general  plan  for 
reUef  and  control  of  tuberculosis.  It  is  gratifying  that  they 
have  done  so.  The  average  patient  reaches  the  new  camp 
earlier  and  with  less  fatigue  than  was  possible  at  Parker  Hill; 
although  it  is  several  miles  farther  from  the  congestion  center. 

Fourteen  patients  appeared  on  the  first  day,  June  5,  and 
withia  a  month  a  waiting  list  was  necessary.  The  Committee 
voted  to  increase  the  capacity  to  seventy-five,  which  number, 
plus  the  staff,  taxed  the  full  capacity  of  the  cook  and  the  stove. 
The  dining-tent  could  be  made  to  seat  but  seventy-two  patients 
at  one  time.  The  rest  of  the  equipment  was  increased  to  eighty 
units.  Our  idea  was  to  admit  eighty-five  applicants  who  could 
not  be  placed  elsewhere  and  by  giving  them  good  food  and  rest 
in  the  open  air,  medical  and  nursing  attention  and  supervision 
of  home  conditions,  strive  for  success  with  each  case  individually. 

The  patients  at  the  Day  Camp  Sanatorium  are  of  an  ad- 
vanced but  still  hopeful  class.  No  one  is  admitted  until  after 
rejection  by  the  examining  board  of  the  Rutland  State  Sana- 
torium, excepting  persons  on  its  waiting  list  who  are  admitted 
to  the  Camp  pending  their  opportunity  at  this  sanatorium  for 
incipient  cases.  In  addition  we  have  persons  barred  from  the 
Rutland  Sanatorium  by  age  (under  fourteen  or  over  forty-five), 
and  a  considerable  number  of  cases  who  had  previously  been 
to  the  Rutland  Sanatorium  and  who  on  this  account  are  not 
re-admissible.  No  one  is  admitted  to  the  camp  who  has  a 
regular  temperature  over  IQl  degrees,  or  whose  general  condition 
is  such  that  he  or  she  would  not  gain  at  the  camp  more  than  the 
cost  in  fatigue  of  getting  back  and  forth  from  home.  Where 
there  is  any  doubt  about  this,  the  patient  is  given  the  benefit 
of  it  and  is  later  discharged  to  a  hospital  if  necessary. 

Patients  are  expected  to  leave  the  Dudley  Street  terminal  at 
8.15  each  morning,  arriving  at  the  camp  at  8.45.  During  the 
first  month  a  special  car  was  hired  by  the  Association  to  carry 
the  patients  to  and  from  the  camp  each  day.     They  objected 

17 


INCREASE    IH 
CAPACITY 


CLASS  OF 
PATIENTS 


HOURS 


TRAirSPOR- 
TATIOn 


REGIME 


EQTJlPMENTj 


PASTIMES 


to  using  it,  being  delayed  by  so  doing;  and  as  there  was  no 
popular  objection  to  the  location  of  the  camp  or  prejudice 
against  its  patients  it  was  discontinued. 

Car-riding  does  not  induce  coughing  and  this  trained  group 
is  more  than  ordinarily  careful  in  regard  to  using  napkins  when 
sneezing,  coughing  and  expectorating.  Throughout  the  summer 
and  fall  months  the  crowd  of  Sunday  travelers  is  so  large  and 
the  extra  provision  made  so  inadequate,  that  we  could  not 
subject  these  sick  people  to  the  brutality  and  delay  to  which 
they  would  be  exposed  by  trying  to  return  home  on  the  ordinary 
cars.  For  this  reason  a  special  Sunday  evening  car  was  suppUed 
as  long  as  the  conditions  warranted  it. 

After  a  short  period  of  rest  their  temperature  and  pulse 
records  are  taken.  Between  9.30  and  10  a.m.  a  lunch  of  bread 
and  butter  and  milk  is  served,  and  eggs  are  given  to  patients 
who  require  them.  On  the  cooler  days  hot  milk  in  the  morning 
and  hot  chocolate  in  the  afternoon  is  served  at  the  lunches. 
At  noontime  a  dinner  consisting  of  meat  or  fish,  two  vege- 
tables and  a  desert,  usually  made  of  milk  and  eggs,  is  served  to 
the  patients  as  they  file  from  the  washstand  by  the  kitchen  to 
the  dining-tent.  The  pulse  and  temperatures  are  again  recorded 
just  before  the  afternoon  lunch.  This  is  served  at  4  p.m.  and 
is  similar  to  the  morning  meal.  On  the  average,  patients  are 
given  an  egg  and  a  half  per  day.  All  are  instructed  to  have  a 
good  breakfast  and  supper  at  home  before  and  after  their  day 
at  the  camp.  Knowing  the  home  conditions  and  watching  the 
pulse  and  temperature  on  arrival  at  the  camp  the  physician 
in  charge  of  the  patients  is  able  to  judge  closely  through  ques- 
tioning as  to  how  far  this  requirement  is  hved  up  to. 

Every  patient  is  provided  with  a  reclining  chair  and  there 
are  in  addition  several  hammocks  for  general  use.  Two  rest 
tents,  each  containing  two  cot  beds,  are  provided  for  emergency 
use  and  any  patient  showing  a  temperature  above  100  degrees 
is  sent  immediately  to  rest.  In  one  instance  a  patient  who  had 
a  hemorrhage  during  the  afternoon  was  kept  at  the  camp  over 
night  in  order  to  avoid  the  danger  of  disturbance  in  returning 
either  to  her  home  or  to  a  hospital.  The  nurses  very  generously 
took  turns  in  constant  attendance  upon  her. 

Several  of  the  daily  newspapers  contribute  copies  regularly; 

18 


in  addition  magazines  and  books  are  provided  for  the  patients 
and  they  are  allowed  to  use  these  as  long  as  their  condition 
is  normal.  The  women  bring  sewing  and  work  upon  it  to  a 
limited  extent.  The  men,  with  a  few  exceptions,  are  allowed 
to  smoke  in  the  afternoon  and  to  play  cards,  checkers  and 
dominoes.     Ring-peg  is  very  popular. 

The  sexes  seem  to  segregate  themselves  quite  naturally  and 
it  is  scarcely  ever  necessary  to  refer  to  the  division  of  space 
allotted  to  one  group  or  the  other. 

Daily  attendance  at  the  camp  is  required  of  every  one  on 
the  rolls.  Persons  whose  records  are  good  are  excused  occa- 
sionally for  their  Sabbath  celebration.  Where  this  privilege 
results  ia  any  apparent  harm  through  increase  in  temperature 
or  pulse  on  the  following  day,  or  loss  of  weight,  it  is  not  renewed, 
but  such  a  patient  is  occasionally  given  permission  to  bring 
some  friend  to  the  camp  for  the  whole  of  or  part  of  a  day. 

After  one  day's  absence  without  excuse  the  nurse  of  this 
Association  makes  a  visit  to  find  out  the  cause.  The  third 
absence  without  acceptable  excuse  forfeits  the  patient's  place 
to  someone  on  the  waiting  list  whose  desire  for  health  is  more 
consistently  shown.  Persons  thus  discharged  are  referred  to 
the  out-patient  department  of  the  Boston  Consumptives 
Hospital  for  observation.  Any  who  become  careless  of  infect- 
ing public  places  or  a  nuisance  to  their  families  may  be  sent  to 
the  Long  Island  or  the  Tewksbury  hospitals  under  quarantine. 

To  complete  this  scheme  of  day  care  and  to  make  it  more 
nearly  approximate  hospital  care  and  control,  we  have  sent 
graduate  nurses  to  the  homes  when  admitting  patients  and 
periodically  afterward.  We  had  to  know  at  once  whether  the 
home  quarters  were  at  all  satisfactory  and  to  have  our  own 
basis  of  judgment  as  to  the  ability  of  the  family  to  sustain  it 
without  undue  strain.  We  had  also  to  know  whether  fumiga- 
tion and  general  housecleaning  were  in  order  and  whether  there 
were  others  in  the  family  who  ought  to  be  examined  and  looked 
after.  Sometimes  such  a  visit  resulted  in  the  discovery  that 
the  family  could  afford  to  pay  for  the  sustenance  of  the  patient. 
We  needed  disinterested  testimony  as  to  home  life  and  its  in- 
fluence on  the  patient's  peace  of  mind  and  rest  of  body.  Families 
being  assisted  by  benevolent  individuals  or  societies  should  be 

19 


REGULAR 

ATTENDANCE 

REQUIRED 


HOME 
SUPERYISIOH 


EDUCATING 

THE 

PATIENT'S 

FAMILY 


IN  THE 

EVENING 

ALL  ARE 

TOGETHER 


204  PATIENTS 
IN  FIVE 
MONTHS 


UP  TO  83  IN 
A  DAY 


COST 


known  as  entities.  Certain  situations  can  only  be  dealt  with 
adequately  by  knowing  and  directly  influencing  every  factor. 
We  cannot  assume  that  directions  are  carried  out  regarding 
early  retirement,  open  windows,  sleeping  alone,  cleanliness  and 
the  general  best  adaption  of  home  conditions  to  health 
improvement.  Prejudice  against  direct  "night  air,"  and  behef 
that  tuberculosis  is  hereditary  and  incurable  except  under 
exceptional  conditions  of  high  altitude  and  dry  atmosphere, 
are  still  all  but  universal.  Because  there  is  a  general  behef 
that  a  true  consumptive  must  be  feeble  and  emaciated  while, 
in  fact,  most  of  those  in  the  first  and  second  stages,  and  a  growing 
percentage  of  those  in  the  third  stage,  look  robust,  their  stated 
inability  to  work  or  request  for  a  special  costly  diet  is  frankly 
thought  to  be  selfish  by  their  families. 

In  order  to  enforce  the  necessary  directions,  sustain  the  sick 
person  before  his  family  and  remove  prejudices,  know  the  whole 
family  and  see  it  as  a  group,  we  have  adopted  a  plan  of  work 
which  permits  the  nurse  to  make  one  or  more  evening  visits  to 
the  patients  in  their  homes.  The  results  obtained  amply  maintain 
this  judgment.  The  sick  are  better  understood  and  cared  for  by 
their  famihes;  and  encouraged  by  such  visits  at  indefinite  periods, 
they  foUow  more  faithfully  that  strict  regime  of  life  which  is 
necessary  to  upbuild  the  system  and  regain  health. 

Concrete  figures  in  regard  to  institutions  should  be  interest- 
ing evidence  as  to  efficiency.  On  October  31,  the  end  of  previous 
seasons  and  of  the  fiscal  year  of  the  Association,  204  patients 
had  been  admitted  to  the  camp.  From  the  middle  of  July 
to  the  middle  of  October,  85  were  kept  on  the  rolls.  This  num- 
ber of  possible  patients  reduced  by  the  average  daily  absences 
due  to  periodic  and  occasional  sickness,  bad  judgment  and 
family  comphcations  gave  the  maximum  utility  to  the  equip- 
ment and  force  except  on  very  stormy  days.  Omitting  the 
month  of  June  during  which  we  were  assembling  the  patients 
there  has  been  a  daily  average  attendance  of  70^.  Including 
June  it  was  67  as  compared  with  46  and  31  in  the  previous 
seasons.  In  162  days,  the  total  for  last  year,  we  have  given 
over  11,000  days'  treatment  as  compared  with  7,522  last  sum- 
mer, an  increase  of  about  30  per  cent. 

The  cost  of  maintaining  the  camp  was  58  cents  per  patient 


20 


« 


per  day  averaged  for  the  fii'st  five  months.  This  compares 
with  82.7  cents  average  for  the  first  season,  and  63.8  for  the 
second.  As  each  month  has  shown  a  saving  over  the  previous 
one  it  seems  probable  that  this  cost  can  be  stOl  fm-ther  reduced 
when  averaged  for  a  year  around.  The  figures  given  include 
the  cost  of  additions  to  and  replacement  of  the  equipment. 
If  these  be  eliminated  the  cost  for  this  year's  regular  season 
was  51  cents  per  patient  per  day.  Of  this  31J  cents  represents 
the  cost  of  the  meals.  The  balance  equals  the  cost  of  the 
local  administration  and  medical  care.  The  cost  has  been  met 
by  voluntary  contributions  from  167  people,  plus  25  cents  a 
day  from  7  patients  who  were  able  to  pay  this  for  a  short  time, 
and  small  payments  by  two  neighboring  cities  whose  Boards  of 
Health  sent  patients  to  us. 

The  following  social  and  medical  statistics  and  information 
were  furnished  by  Dr.  Townsend  and  Miss  Gallagher. 

The  sexes  were  nearly  equally  divided.  One-half  of  all  were 
native  born,  33  were  born  in  Ireland,  25  in  Russia,  23  in  Canada. 
Fifteen  were  under  14  years  of  age,  173  between  14  and  45,  and 
16  over  45. 

Housing  and  household  conditions  were  not  completely 
recorded.  The  residence  of  185  was  in  Boston  and  of  19  in  the 
suburbs.  One  hundred  thirty-five  lived  in  tenement  houses 
with  their  families,  64  boarded  or  lodged  and  8  lived  in  their 
own  houses.     One  hundred  sixty-four  had  separate  rooms. 

Eighty  of  the  patients  had  been  employed  in  factories  or 
shops,  138  had  been  employed  in  confining  occupations,  20  had 
been  attending  school,  and  only  21  reported  outdoor  work. 
Forty-five  had  given  their  time  to  household  tasks. 

Medicine  has  been  used  only  symptomatically.  Sweet  oil  is 
not  used  because  we  feel  that  the  patients  receive  varied  and 
nourishing  diet  in  sufficient  quantities  to  render  it  unnecessary. 
It  has  not  been  deemed  advisable,  after  careful  consideration,  to 
administer  tuberculin  treatment  at  the  camp.  The  body  weight 
of  each  patient  is  recorded  once  a  week.  Every  patient  is 
given  a  thorough  chest  examination  once  a  month  and  a  general 
examination  on  request.  The  throat  of  each  patient  is  ex- 
amined on  admission  by  a  specialist,  who  also  comes  to  the 
camp  twice  each  week  to  give  necessary  treatments. 

21 


THREE- 
FIFTHS 
FOR  FOOD 


AGE,  SEX 

AKD 

NATIONALITY 


HOUSING 


OCCUPATION 


MEDICINE 


EXAMINA- 
TION 


THROAT 
CONDITIONS 


75  PER;  CENT 

LOOKED 

WELL 


SOURCE  OF 
CONTAGION 


14  GAINED 
OVER  TEN 
POUNDS  IN 
20  WEEKS 


THE  REST 
OF  THE 
FAMILY 

EXAMINED 


The  throat  examinations  showed  126  normal  and  56  with 
definite  evidence  of  tuberculosis.  Twenty-two  remained  for  so 
short  a  time  that  they  were  not  examined. 

Three  patients  were  determined  after  careful  scrutiny  not  to 
have  tuberculosis.  Twenty-five  were  suitable  for  hospital  care 
only. 

Of  the  patients  25  per  cent  were  well  developed  and  nourished  and 
showed  no  outward  signs  of  the  disease.  A  further  50  per  cent 
were  so  well  in  appearance  that  they  would  escape  the  layman's 
attention,  while  but  25  per  cent  presented  the  haggard  appearance 
and  other  indications  usually  thought  to  accompany  the  disease. 

As  to  the  source  of  the  contagion  nothing  definite  is  known. 
Tliere  had  been  recorded  cases  of  tuberculosis  in  recent  years 
in  nineteen  of  the  houses  and  in  twenty- two  of  the  family  groups. 
Five  thought  they  caught  the  infection  from  fellow  workmen. 

Microscopic  examination  showed  bacilli  in  the  sputum  of 
42  per  cent  of  the  patients  when  they  entered. 

One  hundred  and  twenty-two  patients  gained  in  weight,  59 
lost  and  43  were  either  weighed  but  once  or  showed  no  material 
change.  Slow  and  steady  gain  in  weight  and  commensurate 
improvement  in  strength  and  condition  were  sought.  From 
half  a  pound  to  a  pound  per  week  was  more  commended  than 
eleven  pounds  in  three  weeks  or  twenty-one  in  ten. 

Ninety-six  children  and  36  adult  members  of  families  in 
which  there  was  known  to  be  a  case  of  tuberculosis  were  ex- 
amined during  the  regular  season.  Of  these  17  were  found  to 
be  tuberculous,  6  in  suspicious  condition,  11  had  bronchitis, 
10  had  enlarged  tonsils,  or  adenoids,  2  anaemia,  4  spinal  curva- 
ture —  leaving  a  balance  of  80  normal.  Each  of  those  needing 
medical  care  was  referred  to  the  proper  agency. 

One  of  the  most  startling  disclosures  of  the  medical  records  was 
the  sources  from  which  the  patients  were  referred  to  our  camp : 

Rutland  State  Sanatorium 34 

Massachusetts  General  Hospital  (Social  Service)  ...  39 

Boston  Dispensary 43 

Boston  Consumptives  Hospital,  O.P.D 8 

Children's  Hospital        1 

Mount  Sinai  Hospital 8 

Boston  City  Hospital 9 

Through  our  office,  Ex-Camp  cases 11 

22 


From  Tuberculosis  Classes 7 

Charitable  Societies 6 

Rutland  Examining  Clinic 10 

Direct  Application 5 

Private  physicians 23 

Total 204 


One  hundred  and  thirty-four  of  these  cases,  or  nearly  two- 
thirds,  had  been  previously  treated  for  tuberculosis  in  sana- 
toriums,  hospitals,  or  classes.  In  consequence  a  special  study  of 
a  group  of  such  cases  who  had  been  in  one  of  the  best  of  our 
sanatoriums  is  now  being  made. 

The  results  have  been  highly  encouraging.  Within  the  five 
months,  of  which  account  is  here  given,  ten  patients  were  dis- 
charged with  the  disease  arrested  and  they  have  resumed  their 
work  and  ordinary  place  in  life.  Fifteen  who  were  at  first 
inadmissible  have  been  secured  places  in  the  Rutland  or  other 
sanatoria  or  hospitals.  Twelve  have  died  at  home  or  at  in- 
stitutions to  which  they  were  sent.  Eleven  of  these  died  from 
tuberculosis.  Fifty-six  left  against  advice,  6  were  discharged 
as  unmanageable  and  the  balance,  95,  remained  on  the  roll  on 
November  1. 

Eliminating  the  42  patients  who  stayed  less  than  a  week,  we 
find  that  the  average  patient  stayed  at  the  camp  for  twelve 
weeks  up  to  November  1st.  At  that  time  there  were  54  patients 
who  had  been  there  for  the  full  twenty  weeks,  74  had  been 
there  more  than  fifteen  weeks,  96  more  than  ten  weeks  and  122 
for  five  weeks  or  more. 

The  Day  Camp  Committee  wishes  to  make  very  grateful 
acknowledgment  of  its  indebtedness  to  Dr.  Townsend,  physician- 
in-charge,  and  to  Drs.  McCarthy,  Houghton,  Schmidt,  and 
Sullivan,  his  volunteer  assistants,  and  to  Miss  Robbins,  matron, 
and  the  other  members  of  the  staff  for  their  tireless  efforts 
which  are  so  largely  responsible  for  the  continued  success  of 
the  Day  Camp  Sanatorium.  The  Committee  also  acknowledges 
with  gratitude  the  generous  volunteer  service  of  Miss  TUeston 
and  Mrs.  Carver;  the  constant  kindness  and  good  neighborliness 
of  the  fellow  tenants,  the  Conness  and  Meehan  families;  the  faith- 
fulness and  cheerful  performance  of  the  nurses  and  the  kitchen 
help  under  trying  circumstances;  the  gentleness,  regularity,  co- 

23 


ONE  THIRD 

HAD  NOT 

BEEN 
TREATED 
BEFORE 


TEN 
"ARRESTED' 


FIFTEEN 
GRADUATED 
TO  RUTLAND 


AVERAGE 
STAY  12 
WEEKS 


operation  and  high  courage  of  the  patients,  without  which  all  else 
would  be  vain;  many  lesser  but  appreciated  gifts  of  services  and 
supplies  from  the  Trustees  of  the  Boston  Consumptives  Hospital, 
the  Boston  Young  Men's  Christian  Union,  the  Boston  Elevated 
Railway  Company,  Walter  Baker  Chocolate  Company,  Walter 
M.  Lowney  Chocolate  Company,  Miss  L.  R.  Little,  Shepard  & 
Norwell,  Houghton  &  Button,  R.  H.  White,  Jordan  Marsh  &  Co., 
Thomas  Kelly  &  Sons,  Mrs.  WUliam  L.  P.  Boardman,  Mrs. 
Skinaer,  Mrs.  J.  S.  Howe,  Mrs.  W.  H.  Smith,  Mrs.  E.  D.  Town- 
send,  Miss  A.Tileston,  Mrs.  Edward  L.  Clark,  Mrs.  J.  G.  Brooks, 
Mrs.  Charles  Gillis,  Mrs.  J.  Button,  Mrs.  G.  T.  Baker,  Miss  A.  R. 
Townsend,  Miss  Alice  Richards,  Mrs.  A.  E.  Hatch,  Miss  B.  Stone, 
Miss  S.  S.  Watson,  Mrs.  Hodgden,  Mrs.  C.  K.  Cummings,  Mrs. 
William  T.  Bowles,  Miss  S.  J.  Elder,  Mrs.  J.  E.  Swan,  Robert  T. 
Paine,  B.  J.  McBonald,  N.  K.  Wood,  C.  P.  Jaynes,  The  Traveler, 
The  Transcript,  Herald,  Post,  Journal,  Globe,  and  American  for 
newspapers  furnished  for  the  patients,  and  to  the  press  generally 
for  helpful  publicity.  Thanks  are  heartily  given  to  each  of  those 
whose  generosity  has  made  this  the  longest  and  most  successful 
season  possible  and  especially  to  the  three  anonymous  givers 
of  five  thousand  dollars.  With  these  funds  the  work  will  be 
continued  until  the  city's  buUding  operations  begin. 


24 


WHERE  CURE  BREAKS  DOWN 

When  a  patient  leaves  Rutland  for  Boston,  the  Superintendent     ex-patiekts 
punctually  sends  us  his  name,  prospective  address,  the  next 
friends'  address,  and  his  condition  on  discharge,  i.e. 

Apparently  Cured,  Improved, 

Disease  Arrested,  Process  Active, 

Much  Improved,  Left  Against  Advice, 

Not  Considered  (the  stay  being  so  short  that  there  was  no 

basis  for  a  report  except  the  entrance  card),  and 
Non- tuberculous  (cases  which  remain  doubtful  after  repeated 

examinations  at  a  clinic  are  admitted  for  observation  during 

an  indefinite  period). 


The  filing  of  this  notice  places  the  ex-patient  on  the  office 
books  for  after  care  which  ought  to  take  the  form  of  a  prompt 
advisory  and  observation  visit  by  the  Association  nurse.  Few 
of  the  patients  have  applied  to  us  for  advice  or  aid  immediately 
upon  their  arrival  in  Boston,  but  the  number  ultimately  be- 
coming dependent  has  reached  proportions  that  demands  serious 
inquiry  into  the  reason  why  the  costly  work  of  cure  has  to  be 
repeated. 

In  the  division  of  labor  at  the  office  of  the  Association  first 
attention  has  been  given  to  newly-discovered  cases  because 
they  are  usually  in  the  second  and  third,  or  the  advanced  stages, 
and  are  ignorant  of  what  to  do  for  themselves,  and  how  to 
protect  others  from  infection.  The  Day  Camp  patients  are 
next  in  turn,  for  we  have  sole  medical  control  over  them,  and 
the  responsibility  for  the  health  of  their  family  imit  is  also  on 
our  shoulders.  Our  final  concern  has  been  with  those  who 
presumably  have  learned  how  to  take  excellent  care  of  them- 
selves, and  who  should  have  been  instructed  concerning  their 
activities  when  they  left  Rutland.  They  should  now,  therefore, 
rank  among  the  assets  and  not  the  liabilities  in  the  business 
of  cure. 

25 


THE  THEORY 


ITS  COLLAPSE  But  it  was  noted  in  October  that  34  of  the  91  patients  on 
the  roll  of  the  Day  Camp  had  been  treated  at  other  sanatoria, 
and  that  the  period  between  discharge  and  the  application  to 
us  as  reverted  cases  in.  the  second  or  third  stage  was  surprisingly 
brief.  At  this  juncture  the  story  of  Mary  Jones  reached  the 
oflSce.  She  had  been  discharged  from  Rutland  this  summer 
A  FAILURE  after  twelve  weeks  of  treatment,  "disease  arrested."  Her  small 
savings  had  been  drained  of  $55  and  the  State  had  spent 
$74.  for  her  maintenance  besides  an  uncomputed  amount  in 
interest,  depreciation,  and  lost  taxable  values  on  its  property. 

Warned  on  leaving  to  "hve  according  to  the  rules  of  hygiene 
learned  at  the  sanatorium,"  she  returned  happy  and  hopeful 
to  her  old  work  of  scrubbing  office  floors  on  her  hands  and 
knees  with  a  brush.  On  the  third  day  the  severe  exercise  of 
chest  and  back  muscles  caused  a  hemorrhage,  which  was  followed 
by  renewed  activity  of  the  disease  process.  No  one  had  talked 
with  her  before  it  was  too  late,  about  her  previous  occupation 
and  the  unwisdom  of  returning  to  it,  and  no  one  had  assisted 
her  to  select  and  obtain  another  means  of  livelihood.  A  second 
arrest,  if  effected  at  all,  must  be  in  spite  of  broken  faith  and 
advanced  condition.  She  will  also  be  treated  by  a  different 
group  of  doctors  and  nurses  who  must  duphcate  the  wasted 
acquaintance,  time,  energy  and  skUl. 

The  Committee  on  Relief  and  Control  then  decided  to  seek 
in  the  records  of  this  type  of  cases  the  answers  to  these  questions : 

To  what  extent  is  the  reversion  due  to  the  occupation? 
WHY?  To  home  conditions? 

To  an  inadequate  period  or  character  of  treatment? 
To  lack  of  instruction  or  failure  to  understand  instruction  at 
discharge? 

The  physician  in  charge  of  the  Camp  selected  nine  of  the 
thirty-four  cases  as  "relapses  probably  due  to  industrial  occu- 
pation," during  the  interval  between  the  discharge  and  the  new 
application.  Four  cases  were  added  to  these  on  information 
subsequently  obtained  from  the  visiting  nurse,  which  indicated 
a  similar  cause  for  their  relapse.  The  remaining  twenty-one 
have  not  yet  been  considered.    Neither  the  social  record  at  the 

26 


METHOD  OF 


office  nor  the  medical  records  at  the  Camp  yielded  satisfactory 
data  on  the  home  life  or  occupation  —  a  failure  due  in  part  to 
the  card  form,  and  in  part  to  the  indifference  with  which  we 
have  all  regarded  these  subjects.  The  facts  were,  therefore,  inquirt 
sought  directly  from  the  patients  in  conversation  carried  on 
informally  without  note  taking  or  set  questioning.  Not  more 
than  two  or  three  histories  could  be  taken  each  day  by  the 
volunteer  who  gave  all  her  time  to  it.  Time  and  tact  were 
required  to  replace  reticence  by  friendliness,  and  reach  the 
spontaneous  natural  point  of  view.  When  each  story  was 
finally  written  the  salient  facts  were  checked  against  official 
records  and  information  given  by  the  Camp  physicians  and 
matron,  and  the  visiting  nurses. 

The  following  cases  are  outlined  in  their  most  abbreviated 
form  and  can,  of  course,  convey  little  of  the  powerful  impression 
made  by  the  detailed  recital  of  hardships,  courage,  and  defeat. 
All  lived  outside  of  Boston,  but  within  ten  miles  of  the  city. 

Case  No.  156. Age  29.  He  says  that  Rut- 
land Doctors  told  him  after  three  months'  treatment, 
three  years  ago,  not  to  leave  the  sanatorium,  but  he  had 
to  go  to  work  to  support  his  family,  and  a  brother,  who 
remamed  at  Rutland.  He  left  the  sanatorium  "im- 
proved," but  he  said  he  "arrested  himself"  by  taking 
a  place  as  freight  brakeman  and  staying  out  of  doors 
all  the  time.  He  was  examined  at  intervals,  and  al- 
though he  felt  well,  the  trouble  did  not  entirely  dis- 
appear. His  brother  was  then  dismissed  from  Rutland 
to  die.  C.  said  that  it  was  necessary  to  take  care  of  his 
brother,  although  he  knew  that  he  should  not  do  so. 
He  worked  all  night  and  took  care  of  his  brother 
during  the  day,  and  attributes  his  second  infection 
to  this  cause.  He  grew  more  and  more  tired,  and 
lost  all  that  he  had  gained.  He  entered  the  Camp 
July  30,  1907,  "second  stage  active." 

Case  No.  141. Twenty-five  years  old.     Was 

discharged  from  Rutland  after  five  months'  treatment,  in 
September,  1906,  "arrested."  Says  that  she  was  told 
that  she  must  never  work  again,  and  she  stayed  at 
home  imder  adnurable  conditions  for  two  months,  and 
then  returned  to  her  former  occupation  as  telephone 
operator.     The  hours  were  from  eight  to  six,  and  the 

27 


work  nerve- wearing,  but  she  did  not  miss  a  day  during 
nine  months  until  too  ill  to  go  to  work.  She  entered 
Camp,  August  13,  1907,  first  stage  active.  Hopes  to 
find  a  place  as  a  switch  board  operator  in  a  private  office 
near  the  window  and  with  shorter  hours.  Discharged 
from  Camp,  November  15,  "arrested." 

Case  No.  76. Thirty-four  years  old.   Admitted 

to  Rutland  about  December  1,  1906,  discharged  AprU  6, 
1907  (twenty  weeks),  "arrested."  The  patient  under- 
^  stood  that  she  was  cured  and  in  the  "best  of  health," 
but  ought  not  to  work  for  a  year  or  two.  She  is  a 
mdow  with  six  stepchildren  and  three  of  her  own, 
only  two  of  whom  are  wage  earners.  Returned  to 
house  work,  doing  as  little  as  possible,  remembering 
advice  —  and  her  household  showed  it.  Admitted  to 
Camp,  June  27,  stage  two,  active.  Discharged  Novem- 
ber 25,  "arrested." 


COHCLUSIONS 


UNSCIENTIFIC 
SOCIAL  CARE 


Time  prevented  the  completion  of  this  study  before  the 
rendering  of  this  report  but  the  conclusion  already  seems  clear 
that: 

Our  knowledge  of  the  patient  ceases  to  be  exact,  scientific 
or  trustworthy  when  he  leaves  the  sanatorium;  and  the  social 
study  of  the  patient  is  at  no  time  comparable  in  method  to  the 
physical  study  of  the  case. 

The  theory  of  medical  care  is  scientifically  outlined  and 
accurately  pursued.  Social  care,  on  the  other  hand,  is  neither 
scientifically  planned  nor  is  the  loose  attention  we  do  give  to 
it  adequate  to  any  one  of  the  requirements  of  a  patient  suddenly 
removed  from  a  nearly  perfect  environment  to  one  full  of  danger. 
When  a  man  asks  for  medical  aid  he  is  studied  so  thoroughly 
that  the  color  of  his  eyes  and  his  mother's  maiden  name  are 
known  before  he  enters  the  ward.  What  is  known  of  him, 
and  by  what  responsible  body,  when  he  re-enters  the  city? 
Yesterday  it  had  been  determined  whether  he  could  digest 
eggs;  today  no  one  inquires  whether  he  can  be  a  bookkeeper 
or  a  man-of-all  work  for  twelve  hom's  a  day. 

Thirty  years  ago  those  who  wished  to  know  how  to  control 
this  disease  were  defeated  in  the  medical  laboratory;  now  we 
fail  hi  the  social  gi'oup;  and  it  is  here  that  we  must  experiment 
with  researches  as  lavish,  as  patient  and  as  daring  as  were 

28 


those  that  discovered  the  bacillus.  We  have  now  to  find  the 
method  by  which  an  ex-patient  can  five,  and  be  as  safe  and 
comfortable  in  his  daily  life  as  in  the  sanatorium. 

Such  reversions  constitute  defeat.  How  shall  we  proceed  to 
reduce  their  number?  How  shall  we  at  least  reduce  the  speed 
with  which  they  overtake  ex-patients  and  nullify  the  expendi- 
ture of  time  and  effort  and  money?  How  shall  the  social 
care  be  brought  up  to  an  efficient  standard? 

The  average  length  of  treatment  at  the  New  York  State 
Sanatorium  at  Ray  brook  is  thirty- two  and  one-half  weeks, 
at  Loomis  and  Sharon  it  is  twenty-four  weeks,  approximately 
the  same  as  at  Rutland.  Should  an  attempt  be  made  to  lengthen 
this  in  order  to  be  surer  of  permanent  results? 

Can  we  not  include  in  the  hygienic  and  medical  treatment 
constant  therapeutic  use  of  various  kinds  of  work?  Con- 
fidence and  abihty  would  thus  be  incidentally  constructed 
while  muscles  are  made  firm,  appetite  created,  and  the  system 
regulated.  Dr.  Patterson,  of  the  Brompton  Hospital  Sana- 
torium, and  other  English  physicians,  have  been  showing  aston- 
ishing results  from  this  method  of  dosing  with  measm-ed  output 
of  activity  and  strength  through  time.  Can  we  protect  the 
convalescent  and  economize  for  the  state,  insuring  the  pro- 
ductiveness of  its  expenditure  upon  him,  by  estabhshing  at 
the  Rutland  Sanatorium,  and  at  the  other  sanatoria  soon  to  be 
erected,  a  social  service  or  after-care  department? 

Enghsh  public  and  private  sanatoria  have  had  ten  years  of 
beneficial  work  by  after-care  committees.  American  experience 
with  after-care  for  graduates  from  insane  asylums  and  the 
parole  system  is  analogous.  We  befieve  it  could  be  built  up 
at  very  slight  cost  through  centrahzing  the  responsibihty  in  a 
developed  graduate  of  a  school  for  social  workers.  No  patient 
would  then  be  discharged  without  this  officer's  knowledge 
except  upon  one  week's  notice  to  her.  In  that  time  she  should 
be  able  to  make  at  least  temporary  arrangements  for  the  patients. 
Through  the  use  of  present  organizations  and  correspondents 
she  could  assure  proper  housing  and  work,  which,  if  not  ideal, 
would  at  least  not  be  dangerous. 

For  the  sake  of  society  and  the  adjustment  of  its  refief  and 
control  measures  we  believe  that  we  need  as  extended  and 


LONGER 
TREATMENT 


PRESCRIBE 
WORK 


AFTER  CARE 


29 


thorough  an  investigation  into  the  after-history  of  sanatorium 
patients  as  we  now  have  into  their  case  history  at  such  scientifi- 
cally governed  institutions  as  the  Phipps  Institute  in  Phila- 
delphia. These  after-history  facts  have  the  same  bearing  on 
control  and  relief  measures  as  laboratory  research  and  the 
minute  antecedent  facts  found  at  the  clinic  have  on  the  medical 
treatment  of  the  individual. 


EDUCATION 

Pubhc  education  on  the  facts  about  pulmonary  tuberculosis 
or  consumption  has  been  sought  through  the  use  of  our  traveling 
exhibit,  public  meetings  and  lectures,  distribution  of  literature, 
representation  at  hearings  on  aU  matters  affecting  health  before 
the  legislature,  and  furnishing  the  press  with  authoritative 
information.  We  have  constantly  reiterated  the  truth  that 
the  "white  plague,"  and  many  other  human  ills  are  preventable 
and  curable  through  consistent  observation  of  the  laws  of 
hygiene,  Consimiption  is  not  hereditary,  but  gets  its  grip  when 
vitality  is  lowered  by  poor  food,  deficiency  of  fresh  air  and 
sunhght,  and  drinking  or  other  excesses.  It  will  not  yield  to 
anything-in-a-bottle  asserted  to  "cure  aU  lung  troubles."  It 
is,  however,  curable  and  preventable  by  homely  means  patiently 
adhered  to :  by  a  concerted  enforcement  of  the  laws  upon  regis- 
tration and  disinfection  of  aU  discovered  cases  and  places;  by 
respect  of  the  law  against  expectoration  or  spitting  on  sidewalks 
and  in  theaters,  churches  and  other  pubhc  places;  by  thorough 
ventilation  of  home,  factory  and  office;  by  hospital  or  other 
medically  supervised  care  of  advanced  cases;  by  sanatorium  or 
dispensary  care  for  incipient  cases;  by  efficient  enforcement  of 
pure  food,  anti-smoke  and  dust,  and  clean  street  laws;  and 
finally,  by  extension  of  buUding  regulations,  and  official  examina- 
tion into  and  care  for  the  health  of  school  children. 

In  practical  demonstration  of  these  truths,  the  Association 
has  arranged  a  traveling  exhibit  of  maps,  charts,  models  of  tents 
and  shacks,  sanatoria  buildings,  photogi'aphs  and  models  of 
consumption  breeding  tenements  and  of  inexpensive  model 
housing  conditions.  Accompanied  by  a  set  of  200  stereoptican 
slides,  it  has  been  set  up  this  year  in  fifteen  cities  and  has  been 

30 


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TO  LEA 

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EXPERIl 


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seen  by  92,000  persons.  Three  times  it  has  passed  beyond  state 
lines,  to  Providence,  Pittsburg,  ajid  Syracuse.  As  a  direct  result 
of  its  service  in  the  latter  city  the  New  York  Legislature  made 
an  appropriation  for  a  duplicate  to  be  used  by  its  State  Board 
of  Health.  Wherever  shown  it  has  either  given  great  impetus 
to  the  local  anti- tuberculosis  society,  or  it  has  caused  one  to  be 
formed  through  precipitation  of  the  aroused  public  interest.  It 
can  be  used  advantageously  in  every  town  of  5,000  inhabitants 
or  over.  The  whole  expense  can  be  kept  within  $100  for  eight 
days.  The  calendar  and  most  economical  route  of  travel  is  made 
up  months  in  advance.  As  the  Treasurer's  report  shows,  the 
receipts  from  its  rental  ($5.00  per  day),  and  the  refunded  ex- 
penses relieve  us  from  the  burden  of  its  support  except  when 
in  local  use.  Constant  effort  is  made  to  improve  it  and  add  to 
its  effectiveness.  The  use  of  an  Edison  phonograph  to  explain 
its  lessons  to  visitors  is  now  projected. 

Encouraged  by  the  great  success  of  the  main  exhibition  and 
the  extended  schedule  made  out  for  its  use  in  the  larger  cities, 
we  are  now  preparing  material  for  minor  or  parlor  exhibits. 
These  will  consist  of  well-selected  photographs  and  charts,  a 
few  models,  and  collections  of  the  best  popular  health  literatm-e. 
These  will  be  lent  to  public  libraries,  settlements,  church  clubs 
and  similar  organizations. 

Forty  public  lectures  were  arranged  in  connection  with  the 
five  local  situations  of  the  exhibit  last  year.  These  were  at- 
tended by  appreciative  audiences  of  from  one  to  nine  hundred. 
"A  War  Upon  Consumption,"  a  leaflet  telling  how  to  escape 
the  disease,  and  "Friendly  Advice  to  Consumptives,"  telling 
the  rudiments  of  treatment  and  the  way  to  protect  others,  are 
distributed  in  large  quantities  to  these  audiences  and  through 
the  office.  We  will  continue  to  arrange  for  lectures  on  health 
protection  before  trades-unions,  settlements,  church  clubs, 
pubUc  schools,  and  other  bodies. 

Special  literature  for  factory  managers  has  been  issued  to  a 
limited  extent,  and  signs  directing  the  use  of  cuspidors  and 
forbidding  indiscriminate  spitting  are  furnished  on  request. 
Several  factories  have  provided  liberally  for  the  examination  of 
their  employees,  for  pensions  while  under  treatment  and  guar- 
antees of  work  when  the  disease  has  been  arrested. 


PUBLIC 
LECTURES 


31 


NEED  OF 

NEW 
ENGLAND 
ORGANIZA- 
TION 


Considerable  of  the  Secretary's  time  is  given  to  visitors 
seeking  information  about  these  subjects  and  ad\T.ce  in  regard 
to  the  inaugm-ation  of  special  campaigns.  This  Association  aims 
to  become,  to  an  increasing  extent,  a  source  of  information  and 
assistance  in  regard  to  every  phase  of  health  protective  work. 
The  largest  and  most  systematic  distribution  of  tuberculosis 
literature  ever  made  was  undertaken  last  January  by  the  City 
Consumptives  Hospital  Department,  when  it  mailed  a  cncular 
to  every  registered  voter  in  Boston.  In  the  preparation  of  this 
circular  the  Secretary  of  the  Association  and  some  of  its  members 
took  an  active  part.  The  Committee  on  Education  expects  to 
prepare  and  distribute  a  new  edition  of  the  "  Directory  of  Institu- 
tions and  Resomxes  in  Massachusetts  for  the  Relief  and  Control 
of  Tuberculosis."  This  has  proven  most  useful  and  is  in  steady 
demand.  The  question  of  including  private  boarding  houses 
brings  up  that  of  the  desirability  of  having  aU  such  "sanatoria" 
and  hospitals  licensed  and  inspected  by  the  State  Board  of 
Health. 

A  general  news  campaign  should  be  begun  by  wsiy  of  furnish- 
ing the  press  of  New  England  regularly  with  stories  about 
health  protection.  The  principal  cost  of  this  enterprise  would 
be  that  of  time  and  skUl  in  preparing  the  articles  at  the  moment 
when  they  have  the  greatest  news  value.  The  solidarity  of  New 
England  interests  is  such  that  this  can  be  done  economically 
only  if  done  for  the  whole,  and  no  local  society  hke  ours  can 
afford  to  bear  the  whole  burden  of  this.  It  would  seem  to  be  an 
excellent  argument  for  the  organization  of  an  Association  of 
all  of  the  health  protective  and  disease  preventive  agencies  in 
these  states.  Progress  requires  a  survey  of  the  health  field  in 
many  communities  now  unorganized,  and  a  re-ahgnment  and 
division  of  labor  among  existing  agencies.  The  standard  of 
work  of  aU  would  be  better  defined.  Volunteer  agencies  would 
be  measm^ed  periodically  b}^  theii-  own  pretensions  and  public 
agencies  by  their  responsibilities. 

WALTER  E.  KRUESI, 

Secretary. 


32 


1905. 

1906. 

1907 

123 

162 

158 

,914 

7,522 

10,580 

31 

46 

67 

58 

72 

83 

DAY  CAMP  SANATORIUM 

COMPARATIVE  FIGURES  FOR  THE  FIRST  TWO  SEASONS 
AND  PART  OF  THE  THIRD  SEASON 

The  Day  Camp  on  Parker  HiU  was  first  opened  July  6,  1905,  closing  for 
the  season  on  October  31.  The  second  season  of  the  camp  opened  May  23, 
and  closed  October  31,  1906.  The  third  season  opened  at  the  new  situation 
in  Mattapan,  June  5,  1907,  and  stiU  continues  as  this  report  goes  to  press 
(January  25,  1908).  All  figiires  are  taken  to  the  end  of  the  fiscal  year  — 
October  31. 


Number  of  days  open 

Total  number  of  patient-days 

Average  number  of  patients  per  day   .    . 
Maximum  number  of  patients  on  one  day, 

Cost  per  day  per  patient: 

Food,  coal  and  medical  suppUes   .    .    .  $0,375  $0,317  $0.3158 

Carriage  to  top  of  Parker  Hill       ....  .144  .093  .025* 

Salaries  of  nurses  and  attendants     .    .  .202  .147  .137 

Office  expenses,  printing,  postage,  etc.    .  .106  .047  .031 

Extensions,  repairs  and  renewals      .    .               .034  .071 

Totals $0,827  $0,638  $0.58 

First  cost  of  camp $1,427.30  

Cost  of  maintenance 3,240.74     $4,803.22    $6,000.69 

Total  disbursements $4,668.04    $4,803.22    $6,000.69 

*  At  the  new  site  no  carriage  is  needed.  This  includes  the  cost  of  the  special  car  for 
the  patients  during  the  first  month  and  on  Sunday  evenings,  and  the  fares  of  two  attend- 
ing physicians. 


SUMMARY  OF  THE  WORK  OF  THE  NURSES 

1906.  1907. 

Gave  instruction  and  advice  to 496  1,149 

Sent  to  hospitals  and  sanatoria 37  188 

Sent  to  Day  Camp 58  45 

Referred  to  the  District  Nursing  Association 21  28 

Referred  to  the  Associated  Charities 49  50 

Referred  to  other  charities 32  33 

Referred  to  the  Board  of  Health 23  f 

Total  number  of  patients  visited 716  1,493 

t  Of  the  total  number  of  patients  coming  under  our  nurses'  care,  378  were  referred  to 
the  Board  of  Health  for  registration,  disinfection,  quarantine  or  on  account  of  overcrowd- 
ing or  illegal  housing  conditions. 

33 


REPORT  OF  THE  TREASURER 

George  S.  Mumford,  Treasurer,  in  account  with  the  Boston  Association 
FOR  THE  Relief  and  Control  of  Tuberculosis. 

Nov.  1,  1906  to  Oct.  31,  1907. 

Dr. 

Debit  Balance  November  1,  1906 $384.70 

To  Contributions  to  General  Fund  of  1907 6,408.24 

Contributions  to  Day  Sanatorium  Fimd  of  1907 6,373.96 

Contributions  to  Day  Sanatorium  Fund  of  1906,  received  after  Nov.  1,  1906,  663.63 

Contributions  to  special  Holy  Ghost  Hospital  Fund 3,539.88 

Contribution  for  Special  Relief  Fund 250.00 

Share  Day  Sanatorium  in  General  Expenses 186.81 

Interest  on  Bank  Balances      36.21 

Cash  sale  of  Napkins,  Pamphlets,  etc 220.18 

Rent  of  Travehng  Exhibit 925.05 


S18,988.66 


Cr. 

By  Salaries      83,749.37 

Office  Rent 250.04 

Office  Expenses,  postage,  traveling  expenses,  etc 1,086.65 

Printing  and  other  Educational  work 376.02 

Traveling  Exhibit 1,379.90 

Relief,  medicine,  sputiun  cups,  etc 176.57 

Cash  transferred  to  Daj' Camp  of  1906  account  after  Nov.  1,  1906     ....  663.63 

Cash  transferred  to  Day  Camp  season  of  1907  account          6,373.96 

Cash  paid  for  board  of  patients  at  Holy  Ghost  Hospital 3,539.88 

Cash  to  repay  loan  of  October,  1906 1,000.00 

Special  ReUef  Fund 101.19 

Balance  on  hand  October  31,  1907 291.45 


$18,988.66 


GEORGE  S.  MUMFORD, 

Treasurer, 

27  KiLBT  Street,  Nov.  29,  1907. 

I  hereby  certify  that  I  have  examined  the  receipts  and  payments,  with  their  vouchers, 
of  the  Treasurer  of  the  Boston  Association  for  the  Relief  and  Control  of  Tuberculosis 
for  the  fiscal  year  ending  Oct.  31,  1907,  and  have  fovmd  them  correctly  accoimted  for 
and  agreeing  with  the  bank  balance. 

H.  A.  LAMB, 

Avditor, 
Ltsbom  Gordon,  Accountant. 


34 


OFFICERS  AND  COUNCIL  FOR  1907-1908 

Edward  O.  Otis,  M.D.,  President.  Mrs.  Mart  Morton  Kehew,  Clerk. 

Arthur  K.  Stone,  M.D.,  Vice-President.     George  S.  Mumford,  Treasurer. 
Walter  E.  Kruesi,  Secretary,  Office,  4  Joy  Street. 


George  S.  C.  Badger,  M.D. 
John  G.  Blake,  M.D. 
V.  Y.  Bowditch,  M.D. 
Arthur  T.  Cabot,  M.D. 
Herbert  C.  Clapp,  M.D. 
Miss  EUzabeth  P.  Cordner. 
Wm.  T.  Councilman,  M.D. 
Mrs.  Charles  A.  Cumndngs. 
Rev.  Francis  X.  Dolan. 
Rev.  Charles  F.  Dole. 
Miss  Helena  Dudley. 
Samuel  H.  Durgin,  M.D. 
Miss  Veronica  Dwight. 
Harold  C.  Ernst,  M.D. 
Mrs.  William  Faxon,  Jr. 
George  W.  Fitz,  M.D. 
Reginald  H.  Fitz,  M.D. 


COUNCIL. 

Mrs.  Helena  N.  Gargan 
Miss  Ahce  L.  Higgins. 
Henry  L.  Higginson. 
Mrs.  John  Homans. 
Miss  Isabel  F.  Hyams. 
EUiott  P.  Joshn,  M.D. 
Mrs.  Mary  Morton  Kehew. 
Frederick  I.  Knight,  M.D. 
Babson  S.  Ladd. 
Horatio  A.  Lamb. 
Rt.  Rev.  WilKam  Lawrence 
Miss  Ida  Mason. 
Edward  F.  McSweeney. 
Prof.  Henry  C.  Metcalf. 
James  J.  Minot,  M.D. 
George  S.  Mumford. 
Miss  Mary  Boyle  O'Reilly. 


Edward  O.  Otis,  M.D. 
Robert  Treat  Paine,  Jr. 
Wallace  L.  Pierce. 
Joseph  H.  Pratt,  M.D. 
Miss  Julia  C.  Prendergast. 
Charles  P.  Putnam,  M.D. 
Miss  Lilian  V.  Robinson. 
Miss  Maud  M.  Rockwell. 
Miss  Annette  P.  Rogers. 
G.  H.  M.  Rowe,  M.D. 
Fred'k  C.  Shattuck,  M.D. 
A.  Shuman. 
Arthur  K.  Stone,  M.D. 
Mrs.  Paul  Thomdike. 
Miss  Ellen  Tower. 
Henry  P.  Walcott,  M.D. 
Robert  Winsor. 


STANDING  COMMITTEES 

EXECUTIVE  COMMITTEE. 


Edward  O.  Otis,  M.D.,  Chairman. 
Rev.  Francis  X.  Dolan. 
Miss  Alice  L.  Higgins. 
Mrs.  Mary  Morton  Kehew. 
Babson  S.  Ladd. 


James  J.  Minot,  M.D. 
George  S.  Mtjmford. 
Charles  P.  Putnam,  M.D. 
Arthur  K.  Stone,  M.D. 
Robert  T.  Paine,  Jr. 


COMMITTEE  ON  EDUCATION  AND  HOSPITALS. 


Arthur  K. 
Rev.  Francis  X.  Dolan. 
Miss  Lilian  V.  Robinson. 
Miss  I.  F.  Hyams. 
Mrs.  Sylvia  Knowlton. 
Edwin  A.  Locke,  M.D. 
Miss  Alice  G.  Chandler. 


Stone,  M.D.,  Chairman. 

Mrs.  John  Homans. 
William  T.  Councilman,  M.D. 
Mrs.  Mary  Morton  Kehew. 
Robert  T.  Paine,  Jr. 
Ralph  C.  Larrabee,  M.D. 
Miss  Mary  L.  Strong. 


35 


COMMITTEE   ON  RELIEF   AND   CONTROL. 

James  J.  JiliNOT,  M.D.,  Chairman.  Cleaveland  Floyd,  M.D. 

Arthur  K.  Stone,  M.D.  Miss  Veronica  Dwight. 

Edward  O.  Otis,  M.D.  Babson  S.  Ladd. 

Charles  P.  Putnam,  M.D.  Miss  Eliz.'Vbeth  P.  Cordner. 

Miss  Julia  C.  Peendergast.  Miss  Alice  L.  Higgins. 

Miss  Ida  Mason.  Mrs.  Helena  N.  Gakgan. 

George  S.  C.  Badger,  M.D.  Harry  Linenthal,  M.D. 

FINANCE   COMMTTEE. 
Mrs.  Mary  Morton  Kehew,  Chairman. 
Mrs.  John  Hoiians.  Robert  T.  Paine,  Jr. 

HoRAyro  A.  Laj,ib.  George  S.  MuiiFORD. 


SPECIAL  COMMITTEES 

DAY   CAJilP   SANATORIUM   COMxMITTEE. 
Mrs.  Mary  Morton  Kehew,  Chairman. 
George  S.  Muiiford.  Mrs.  Charles  K.  CuMinNGS. 

Robert  Treat  Paine,  Jr.  Charles  P.  Putnam,  M.D. 

Arthur  K.  Stone,  M.D.,  Vice-Chairman.    Edwin  A.  Locke,  M.D. 

COlMiHTTEE  ON    TUBERCULOUS    CHILDREN. 
Charles  P.  Putnam,  M.D..  Chairman. 
Miss  Alice  L.  Higgins.  Rev.  Francis  X.  Dolan. 

Miss  Lilian  V.  Robinson.  Harry  I.  Bowditch,  M.D. 

Miss  Helen  Cheever.  Channlng  Stowell,  M.D. 

John  B.  Hawes  2d,  M.D. ,  Fice-C/iairman     Seymour  H.  Stone. 

Edwin  A.  Locke,  M.D. 

COMMITTEE    ON    EMPLOYMENT    FOR  PATIENTS  AND  EX-PATIENTS. 
Joseph  H.  Pratt,  M.D.,  ChaArman. 
Miss  Alice  L.  Higgins.  Walter  E.  Kruesi. 


STAFF 

Secretary Walter  E.  Kruesi 

T7-.  .^-      Tvr  (  Miss  M.  Alice  Gallagher 

Visiting  Nurses -I  ^^         .  •,,  t^ 

(  Miss  Annie  McKay 

Stenographer      Miss   Harriet  I.  Lawrence 

Clerk Mrs.  M.  A.  Curry 

Caretaker  of  Exhibit Arthur  C.  Hunt 

Medical  Director  of  Day  Camp  Sanatorium     .    .    .      David  Townsend,  M.D. 

(  F.  P.  McCarthy,  M.D.  . 
Volunteer  Assistant  Physicians  at  the  Day   Camp  J  R.   H.  Houghton,  M.D. 
Sanatorium J  R.  D.  Schmidt,  M.D. 

I  J.  T.  Sullivan,  M.D.  (Throat) 

Matron  of  Day  Camp  Sanatorium Miss  Susane  F.  Robbins 

Nurse         "  "  "  Miss  Ella  F.  Edwards 

Caretaker   ''  "  "  William  J.  Jutras 

Cook  at      "  "  "  Mrs.   F.  Benson 

Kiichen  Helpers  at  Day  Camp  Sanatorium      ••.•<,,        ..'  ^    ^/  ' 
^  ^  (  Mrs.  J.  E.   Voye 

36 


DONATIONS 


Contributions  of  one  dollar,  or  more,  within  any  fiscal  year 
to  the  general  funds  of  the  Association  entitle  the  contributor 
to  membership.  AVhere  members  have  also  contributed  to  the 
STpecial  fimd  for  the  Day  Camp  Sanatorium  it  is  here  ac- 
knowledged in  combination  with  general  gifts.  Those  who 
have  contributed  to  the  Sanatorium  only,  and  are,  therefore, 
not  enrolled  as  members  are  incUcated  by  an  asterisk. 

Backup,  Elizabeth  E S2.00 


Abbe,  F.  R.,  M.D , 

*Abbott,  Dr.  and  Mrs.  Edward 

Abbott,  Gordon 

*Abbott,  Miss  Katherine  K.  .  . 
*Abbott,  Mrs.  P.  W 

Achorn,  Mrs.  E.  O 

Adams,  Mrs.  Charles  H.     .    .    , 

Adams,  Miss  Helen  J 

Agassiz,  Mrs.  Louis 

*Ahlborn,  Emily  B 

*Aldrich,  Miss  C.  F 

Alford,  Edward  B 

Alford,  Martha  A 

Alford,  Mrs.  Orlando  H.    .    .    . 

Alford,  Orlando  H 

Allen,  Freeman,  M.D 

*Allen,  Mrs.  W.  H 

Allen,  Mrs.  W.  L 

Almy,  Mrs.  Charles 

Ames,  Prof,  and  Mrs.  J.  B.  .  . 
*Ames,  Miss  Mary  L 

Amory,  Arthur 

Amory,  C.  W 

Amory,  Ingersoll 

Amory,  Miss  Susan  C 

Amory,  WilUam 

Amster,  Mrs.  W.  L 

AnonjTnous 


♦Andrews,  Edward  R.      .    . 

Andrews,  Miss  Ellen   .    .    . 

Anthony,  Miss  Annie  R.    . 

Anthony,  Mrs.  S.  Reed  .    . 

Appleton,  William,  M.D.    . 

Armstrong,  Mrs.  George  E. 

Arnold,  George  F 

Arnold,  H.  D.,  M.D.    .    .    . 

Arnold,  Howard  P.     .    .    . 

Atkinson.  Miss  E.  B.  P.     . 

Ayer,  Mr.  and  Mrs.  C.  F.  . 
*Ayer,  James  B.,  M.D.     .    . 


Sl.OO 
5.00 

11.00 
5.00 

10.00 
1.00 
1.00 
3.00 
5.00 
5.00 
5.00 

10.00 
5.00 

15.00 

20.00 
1.00 
5.00 
1.00 
1.00 

50.00 

25.00 
6.00 

25.00 
1.00 
1.00 

50.00 

10.00 
100.00 
5.00 
1.00 
3.00 
5.00 
6.00 
1.00 
5.00 
-  2.00 
5.00 

10.00 
5.00 
1.00 

20.00 
5.00 
1.00 
1.00 

25.00 
1.00 

16.00 
5.00 


Bacon,  Francis  E 

*Bacon,  Mrs.  Louise  C.    .    . 

Bacon,  Miss  M.  P 

Badger,  G.  S.  C,  M.D.  .    . 

Baker,  Miss  C.  Alice  .    .    . 

Baker,  Lorenzo  D.      ... 

Balch,  Miss  Emily  G.     .    . 

Baldwin,  George  S.  .  .  . 
♦Baldwin.  William  H.  .  . 
♦Bancroft,  Mrs.  C.  F.   .    .    . 

Barbour,  E.  D 

Barbrick,  J.  Eraser,  M.D. 
♦Bartlett,  Miss  M.  H.  .    .    . 

Bartol,  Miss  Ehzabeth  H. 

Bartol,  J.  W.,  M.D.     .    .    . 

Bates,  George  P 

Beach,  Mrs.  E.  H 

*Beebe,  E.  Pierson   .... 

Beebe  Mrs.  J.  Arthur    .    . 

Beech,  Mrs.  Herbert  .    .    . 

Belches,  Edward  F.    .    .    . 

Bellows,  Howard  P.,  M.D. 

Bemis,  Albert  F 

Berlin,  Miss  Fanny .    .    .    . 

Bickford,  Miss  O.  A.  .    .    . 

Biglow,  Albert  F 

Bigelow,  Mrs.  Caroline  T. 

Bigelow,  R.  P 

Bigelow,  W.  Sturgis,  M.D. 
♦Billings,  Ehzabeth  C. .    .    . 

Billings,  Rev.  Sherrard  .    . 

Bird,  MissM.  D 

♦Bird,  W.  B 

Blackmar,  Mrs.  Wilmon  W. 

Blake,  Mrs.  Arthur  W.  .    . 

Blake,  J.  A.  L 

Blake,  Miss  M.  L 

Blake,  Mrs.  S.  Parkman    . 

Blake,  William  P 

Blakeley.  David  N.,  M.D. 

Blanchard,  Miss 

Blauchard,  Sarah  H.  .    .    . 

Bloom,  William 

♦Boaman,  James  C.      ... 

Boardman,  Miss  E.  D.  .  . 
♦Boardman,  Mrs.  W.  D.  .  . 
♦Boland,  E.  J 


25.00 

20.00 

1.00 

2.00 

1.00 

5.00 

1.00 

2.00 

3.00 

3.00 

5.00 

2.00 

5.00 

6.00 

1.00 

15.00 

26.00 

25.00 

200.00 

10.00 

1.00 

1.00 

7.00 

1.00 

6.00 

1.00 

35.00 

2.00 

20.00 

1.00 

1.00 

3.00 

2.00 

6.00 

5.00 

10.00 

5.00 

40.00 

10.00 

1.00 

5.00 

5.00 

1.00 

5.00 

1.00 

5.00 

1.00 


37 


Boland,  E.  S.,  M.D Sl.OO 

Borland,  M.  Woolsey      ....  21.00 

Bout  well,  Mrs.  L.  B 5.00 

Bowditch.  Charles  P 10.00 

Bowditch,  Henry  P.,  M.D.       .    .  11.00 

Bowditch,  Miss  Olivia  Y.  .    .    .  1.00 

Bowditch,  Vincent  Y.,  M.D.      .  1.00 

Bowen,  John  T.,  M.D 1.00 

Boyden,  Mrs.  Charles     ....  5.00 

Brackett,  J.  R 5.00 

Bradford,  Cornelia  H 3.00 

*Bradlee,  Mrs.  J 5.00 

Bradlee,  Miss  S.  C 3.00 

Bradley,  J.  Payson 1.00 

Bradley,  Susan  H 1.00 

*Bram4n,  James  C 5.00 

Bramhall.  Eleanor  C 1.00 

Brandeis,  Mrs.  Louis  D.     .    .    .  5.00 

Bremer,  Mrs.  John  L 50.00 

Brewer,  Miss  Fannie  R.      .    .    .  6.00 

Brindisi,  R.,  M.D 1.00 

Brooks,  Fred 5.00 

Brooks,  Gorham 5.00 

Brooks,  John  Arthur      ....  3.00 

Brooks,  Mrs.  Peter  C 50.00 

Brooks,  Mrs.  Shepard     ....  300.00 

Brown,  Arthur  M 1.00 

Brown,  Mrs.  Mary  E 1.00 

*Brown,  Samuel  N 10.00 

Brown,  Miss  Sarah  N 1.00 

*Browning,  Ellen  P 5.00 

Bryant,  Mrs.  John  D 2.00 

Bryant,  Nanna  M 7.00 

Bullard,  Francis      5.00 

Bullard,  Mrs.  William  S.    .    .    .  10.00 

Burnham,  E.  A.,  M.D 1.00 

Burnham,  Mrs.  J.  A 11.00 

Burr,  Mr.  and  Mrs.  Allston   .    .  12.00 

Bushnell,  Rev.  S.  C 1.00 

Byerly,  Prof.  W.  E 15.00 

Byrne,  Rt.  Rev.  William,  V.G.  6.00 

Cabot,  A.  T.,  M.D $16.00 

Cabot,  Charles  M 10.00 

Cabot,  Mrs.  J.  S 5.00 

*Cabot,  Mrs.  Louis 50.00 

Cabot,  Mrs.  Walter  C 20.00 

Call,  Emma  S.,  M.D 1.00 

Callahan,  Bessie 2.00 

Callanan,  S.  A.,  M.D 2.00 

Campbell,  William  R 1.00 

Capen,  Samuel  B 5.00 

Carey,  Arthur  A 5.00 

Carruth,  Miss  Ellen 2.00 

Carson,  Mrs.  H.  A 1.00 

Cary,  Mrs.  Edward  M 201.00 

Gary,  Miss  G.  S 51.00 

*Case,  Mrs.  James  B 20.00 

*Cate,  Mrs.  M.  L 10.00 

Chamberlin,  E.  D 25.00 

*Chamberlin,  Miss  E.  E.       ...  15.00 

Chamberlain,  Miss  Melissa     .    .  6.00 

Chamberlain,  W.  N 1.00 


Chandler,  Mrs.  F.  W S6.00 

Charming,  Dr.  Walter    ....  6.00 

Chapin,  Mrs.  Henry  B 11.00 

*Chapin,  Horace  D 10.00 

*Chase,  Susan  R 2.00 

Chase,  H.  Lincoln.  M.D.    .    .    .  4.00 

*Chase,  Mrs.  Theodore     ....  10.00 

Cheever,  C.  A.,  M.D 1.00 

Cheever,  Miss  Helen 1.00 

Cheney,  Mrs.  Arthur 11.00 

*Chick,  J.  W 5.00 

Chirurg,  M.,  M.D 1.00 

Christian,  Henry  A.,  M.D.     .    .  1.00 

Clapp,  Mrs.  Charming     ....  5.00 

*Clapp,  Mrs.  George  B 5.00 

Clapp,  Herbert  C,  M.D.     .    .    .  1.00 

Clapp,  Mrs.  W.  W 11.00 

Clark,  Mrs.  Frederic  S 5.00 

Clark,  J.  Payson 1.00 

Clark,  Mrs.  John  T 1.00 

Clark,  Miss  Marion  W.   .    .    .    .  20.00 

Clark,  Rev.  William  L 1.00 

*Clarke,  Mrs.  Mary  E 5.00 

Clarke,  Henry  Martyn    ....  4.00 

♦Clement,  Mary  D 5.00 

Cobb,  Andrew  B 6.00 

*Cobb,  Mrs.  Charles  K.,  Jr.     .    .  10.00 

Cobb,  Elizabeth  C 1.00 

Cochrane,  Alexander 6.00 

Codman,  E.  A 1.00 

Codman,  Mrs.  J.  M 20.00 

*Codnian,  J.  S 3.00 

Codman,  Mrs.  R.  S 4.81 

Colby,  Miss  Jennie  M 1.00 

Cole,  Samuel  W 1.00 

Coleman,  Miss  Emma  L.    .    .    .  1.00 

Colfelt,  Mrs.  Rebecca 25.00 

Collamore,  Helen 10.00 

Conrad,  Mrs.  David 1.00 

Converse,  Costello  C 25.00 

CooUdge,  Ellen  G 2.00 

Coolidge,  Ellen  W 2.00 

Coolidge,  Mrs.  F.  S 1.00 

CooUdge,  J.  Randolph    ....  20.00 

Coolidge,  Sidney 10.00 

Coolidge,  T.  JeSerson,  Jr.      .    .  10.00 

Cordner,  Miss  Elizabeth  P.    .    .  5.00 

Cornish,  Mrs.  Louis  C 1.00 

Getting,  C.  E 25.00 

Cotting,  Francis  J 2.00 

CottLng,  Miss 3.00 

*Courings,  Mrs.  W.  H 10.00 

Cowing,  Mrs.  Walter  H.     .    .    .  10.00 

Crafts,  Miss  M.  E 5.00 

Crane,  W.  Murry 26.00 

Crehore,  Mrs.  G.  C 5.00 

*Crocker,  George  G 6.00 

Crocker,  George  U 10.00 

Crocker,  Mrs.  Uriel  H 5.00 

Crosby,  Mrs.  S.  V.  R 10.00 

Cross,  H.  B.,  M.D 1.00 

Crowninshield,  Francis  ....  6.00 

Cruft,  Miss 10.00 


38 


Cummings,  A.  M $1.00 

Cummings,  Mrs.  C.  A 100.00 

♦Ciimnnins,  Charlotte  W.     .    .    .  5.00 

Cummin,  Mrs.  H.  H 1.00 

Cunningham,  Mrs.  F 26.00 

*Curley,  James  M 5.00 

Currier,  Guy  W 10.00 

♦Curtis,  Mrs.  Charles  P 25.00 

Curtis,  Miss  E.  A 1.00 

♦Curtis,  Mrs.  G.  S 10.00 

*Curtis,  Mrs.  H.  G 10.00 

Curtis,  Miss  I.  P 6.00 

Curtis,  Mrs.  James  F 10.00 

Gushing,  Miss  C.  L 1.00 

Cutler,  E.  G.,  M.D 1.00 

Daland,  Mrs.  T $11.00 

*Dalny,  Miss  O.  Fredrica    .    .    .  3.00 

Dana,  Samuel  B 5.00 

Dane,  Ernest  B 100.00 

Daniels,  E.  A.,  M.D 2.00 

Davenport,  F.  H.,  M.D.     .    .    .  1.00 

Davenport,  Mrs.  J.  H 1.00 

*Davis,  Miss  Helen  G 5.00 

Davis,  Mrs.  James  H 1.00 

Davis,  Mrs.  Joseph  E 25.00 

Davis,  Lincoln,  M.D 5.00 

Day,  Mrs.  Caroline 2.00 

Day,  F.  A 15.00 

Day,  Hilbert  F.,  M.D 1.00 

Dearborn,  Miss  Elizabeth  K.     .  1.00 

De  Boer,  David  H 1.00 

Deland,  M.  W 2.00 

Dennen,  Rev.  Ernest      ....  5.00 

Dennie,  The  Misses 2.00 

De  Normandie, 

Rev.  and  Mrs.  R.  L.  12.00 

Derby,  G.  S.,  M.D 1.00 

Devine,  William  H.,  M.D.      .    .  1.00 

Dewey,  Charles  G.,  M.D.   .    .    .  1.00 

Dewey,  Miss  M.  H 1.00 

Dewson,  Mrs.  George  B.    .    .    .  10.00 

Dexter,  George 20.00 

Dexter,  Franklin,  M.D.      .    .    .  10.00 

Dexter,  Miss  Mary  L 2.00 

Dixon,  L.  S 2.00 

Doherty,  Helen  I.,  M.D.    .    .    .  1.00 

Dolan,  Rev.  Francis  X.      .    .    .  5.00 

Dole,  Rev.  and  Mrs.  Charles|F.  11.00 

*Dole,  Francis  D ".    .  2.00 

Doliber,  Mrs.  Ada  Ripley  ...  1.00 

Donovan,  Walter  J 1.00 

Dove,  Mrs.  G.  W.  W 5.00 

Draper,  Frank  W.,  M.D.    .    .    .  1.00 

Dresel,  E.  L 1.00 

*Dresel,  Miss  Lotiisa  L 5.00 

Drummond,  Mrs.  James    .    .    .  2.00 

Dudley,  L.  Anna 1.00 

Duncan,  Mrs.  Samuel  W.  .    .    .  1.00 

Dunn,  Miss  S 1.00 

*Dupee,  Mrs.  W.  A 5.00 

Dwight,  Miss 5.00 

Dyring,  Miss  Hilma 1.00 


E.  T.  E $1.00 

Eaton,  Miss 5.00 

Edwards,  Mrs.  John  C 3.00 

*Eliot,  Mrs.  J.  W 10.00 

Elliot,  George  B 1.00 

Emmerson,  D.  R.  and  Co.     .    .  5.00 

Emmons,  Mrs.  R.  W.  2d     .    .    .  35.00 

Endicott,  Henry 1.00 

Endicott,  William 26.00 

E.  S.  C 25.00 

Ernst,  Mrs.  C.  W 1.00 

Ernst,  Harold  C,  M.D.      .    .    .  10.00 

Estabrook,  A.  T 51.00 

Esty,  Clarence  H 1.00 

Eustis,  The  Misses 6.00 

Evans,  Mrs.  Glendower      .    .    .  10.00 

*  Fabyan,  Mrs.  Francis  W.      .    .  $10.00 

*Fabyan,  Mrs.  George  F.     .    .    .  10.00 

*Fabyan,  Miss  Isabel 10.00 

Fairbairn,  Mrs.  R.  B 6.00 

Farnsworth,  Miss  Alice  ....  10.00 

Farwell,  Mrs.  John  W 5.00 

Faulkner,  Miss  Fannie  M.      .    .  71.00 

Faxon,  Mrs.  William 5.00 

Fay,  Harry  F.' 6.00 

Fay,  Mrs.  H.  H 10.00 

Fay.  WilUamE.,M.D 1.00 

*Fearey,  Mrs.  M.  L 10.00 

*Fegan,  Mrs.  Fannie  H 1,00 

Fenno,  Mrs.  L.  C 11.00 

Fessenden,.  R.  G 6.00 

Field,  Edward  B 10.00 

Fields,  Mrs.  James  T 5.00 

*Fires,  Anna  M 2.50 

*Firth,  William 10.00 

*Fish,  Clara  P 5.00 

*Fiske,  Andrew 5.00 

Fiske,  Mrs.  Charlotte  M.    .    .    .  40.00 

Fiske,  Mr.  and  Mrs.  E.  W.     .    .  2.00 

Fitz,  G.  W 2.00 

Fitz,  Miss  Louise 1.00 

Fitz,  R.  H.,  M.D 5.00 

Fitzgerald,  Mrs.  Desmond     .    .  1.00 

♦Fitzgerald,  Elizabeth      ....  1.00 

Fitzgerald,  W.  T.  A. 1.00 

Fitzpatrick,  T.  B 6.00 

Flagg,  Elisha,  M.D 6.00 

Flint,  Baker,  M.D 1.00 

Folsom,  Miss  Amy 70.00 

Folsom,  Mrs.  C.  F 1.00 

Foo  &  Wing  Herb  Co 1.00 

Forbes,  Francis  B 10.00 

Forbes,  Mrs.  J.  Malcolm    .    .    .  21.00 

Forbes,  J.  Murray 5.00 

♦Forbes,  W.  B 2.00 

Forbes,  Mrs.  William  H.    .    .    .  10.00 

Foss,  Edwin  C 1.00 

Foster,  Mrs.  Alfred  Dwight  .    .  6.00 

Foster,  Mrs.  Anna  S 1.00 

Foster,  Miss  Elizabeth  ....  1.00 

Francis,  G.  T 15.00 

♦Francis,  Mrs.  G.  Y 6.00 


39 


Frank,  Mrs.  Daniel 81.00 

Frankenstein,  Lena  H 1.00 

Freeman,  Mrs.  James  G.    .    .    .  5.00 

♦Freemaji,  Mrs.  L.  A. 2.50 

French,  Miss  C.  A 5.00 

French,  Miss  C.  L.  W 50.00 

French,  Mrs.  John  J 1.00 

Friend 5.00 

1.00 

25.00 

*  "        25.00 

10.00 

*  ••        100.00 

1.00 

*  "        20.00 

"^ 5.00 

"     for  Holy  Ghost  Hospital.  3,539.88 
"      for  Day  Camp     ....   2,089.18 

Frothingham,  Dr.  and  Mrs.  L.  4.50 

Frothingham,  Rev.  Paul  Revere  5.00 

*Fullarton,  Mrs.  Mary  A.     .    .    .  1.00 

Fuller,  Daniel  H 18.00 

Cahn,  Joseph  A S5.00 

Gardiner,  J.  Pennington    .    .    .  6.00 

Gardiner,  Mrs.  R.  H 4.00 

♦Gardner,  George  P 10.00 

Gargan,  Mrs.  Thomas  J.    .    .    .  3.00 

Gay,  Ernest  L 1.00 

Gay,  ilrs.  F.  L 5.00 

Gerry,  Dr.  and  Mrs.  E.  Peabody  2.00 

Gibbs,  L.  D 5.00 

Gibson,  G.  A 26.00 

Giddings,  Mrs.  E.  L 6.00 

Gilman,  Bradley 1.00 

*Ginn,  M.  F.  G 5.00 

Goddard,  G.  A 5.00 

Gordon,  A.  F 5.00 

Gorham,  Mrs.  W.  H 17.00 

*Gosselin,  Louis  V 1.00 

Gray,  Miss  Harriet 50.00 

Gray,  Miss  Isa  E 10.00 

Gray,  Mrs.  Reginald 10.00 

Gray,  Mrs.  Samuel  L 5.00 

Greene,  D.  C,  M.D 1.00 

Greene,  Francis  E 10.00 

Greene,  J.  S.,  M.D 1.00 

Greenough,  Mrs.  C.  P 3.00 

Greenough,  Mrs.  D.  S 5.00 

Greenwood,  Allen,  M.D.     .    .    .  1.00 

Grew,  Mrs.  E.  W 1.00 

Grew,  Mrs.  H.  S 50.00 

Griffith-Stillings  Press    ....  5.00 

Grinnell,  Harold  D 25.00 

Grinnell,  Miss  M.  R 11.00 

Guild,  Mrs.  Charles  E 1.00 

Guild,  Frederic 5.00 

♦Guild.  Mrs.  J.  Anson 1.00 

H.  A.  H.,  In  memory  of     .    .  $51.00 

Hagan,  H.  E 1.00 

Hager,  A.  C 1.00 

Hale,  A.  M 1.00 


Hall,  Mrs.  J.  W $1.00 

Hall,  Thomas,  M.D 1.00 

Hamilton,  Annie  Lee,  M.D.  .    .  1.00 

Hamlen,  Miss  E.  P 15.00 

Hamlin,  Mr.  and  Mrs.  C.  S.  .    .  2.00 

Hamlin,  Mrs.  S.  P 6.00 

♦Hammond,  Mrs.  G.  G 15.00 

Hanks,  Mrs.  Charles  Stedman  .  51.00 

Harrington,  Mrs.  F.  B 1.00 

♦Harrington,  Mrs.  G.  W.      ...  4.00 

Harris,  Henry  W 1.00 

Hart,  W.  0 1.00 

Hartley,  Mrs.  Harry 6.00 

Hartshorn,  Ella  F 1.00 

Haskell,  Mrs.  Mary  C 1.00 

Haskell,  iliss  Mary  E 2.00 

Hayes,  Mrs.  B.  H 5.00 

Hayward,  Miss  Frances.    .    .    .  1.00 

Heath,  E.  de  C 3  00 

Hedge,  Frederic  H 1.00 

Hedges,  Anna  M 1.00 

Helms,  Rev.  E.  J 1.00 

Hemenway,  Mrs.  Augustus   .    .  5.00 

♦Hemenway,  Miss  Clara  ....  10.00 

Herrick,  Miss  M.  F 1.00 

Hersey,  Heloise  E 2.00 

Higgins,  Miss  Alice  L 1.00 

Higginson,  Mrs.  F.  L 11.00 

Higginson,  Ida  A 1.00 

HilL  Miss  Frances  A 5.00 

Hill,  Mrs.  Hamilton 5.00 

♦Hill,-  Mrs.  L.  C 5.00 

Hills,  E.  A 5.00 

HUls,  Warren  G 5.00 

Hobart,  Mary  F.,  M.D.      .    .    .  1.00 

HoUingsworth,  Mrs.  G 10.00 

Homans,  Mrs.  John 15.00 

♦Homans,  Miss  Marion  J.    .    .    .  10.00 

Hoods,  Mary  G.,  M.D 3.00 

Hooker,  Miss  S.  H 1.00 

Hooper,  Mrs.  C.  H 1.00 

Hooper,  Mrs.  Susan  Thayer  .    .  1.00 

Hopkins,  Mrs.  R.  W 1.00 

♦Horton,  Mrs.  W.  H 10.00 

Hough,  Theodore 2.00 

Houghton,  Clement  S 20.00 

Houghton,  Miss  E.  G 1.00 

Houghton,  N.  H 1.00 

♦Houston,  James  A 10.00 

Howe,  E.  P 10.00 

Howe,  Mrs.  George  D 10.00 

Howe,  Henry  S 26.00 

Howe,  James  S 5.00 

♦Howe.  Mrs.  James  S 10.00 

Howe,  Mrs.  R.  H 1.00 

Howland,  Mrs.  Llewellyn  .    .    .  6.00 

Hubbard,  Charles  W 10.00 

Hubbard,  Mrs.  Eliot 15.00 

Hubbard,  Mrs.  Frances  M.    .    .  1.00 

Hubbard,  J.  C 1.00 

Hugo,  George  B 1.00 

H\miphreys,  R.  C 1.00 

Himnewell,  Mrs.  Arthur    .    .    .  25.00 


40 


Hunnewell,  Henry  S S25.00 

Hunnewell,  Jane  B 1.00 

Hunnewell,  Miss  J.  0 11.00 

Hunnewell,  Walter 10.00 

Hunt,  Mrs.  William  D 10.00 

Huntington,  Miss 1.00 

Hutchins,  Mrs.  Edward  W.   .    .  2.00 

lasigi.  Mrs.  Oscar S25.00 

Ireson,  Mrs.  Ellen  W 2.00 

Jackson,  Henry,  M.D S5.00 

*Jackson,  Mrs.  James,  Jr.    .    .    .  25.00 

Jackson,  Miss  Marion  C.     .    .    .  150.00 

Jameson,  Miss  Lillian     ....  1.00 

Jaques,  Mrs.  Francis 15.00 

Jaques,  Herbert 10.00 

Jaques,  Miss  H.  L 11.00 

Jefferson,  Sarah  A 5.00 

Jewett,  Miss  Sarah  Orne    .    .    .  5.00 

Johnson,  Arthur  S 25.00 

Johnson.  Edward  C 15.00 

Johnson,  Mrs.  Samuel    ....  6.00 

Johnson,  Wolcott  H 5.00 

*Jones,  Miss  Dorothy  B.      ...  5.00 

*Jones,  Mrs.  Otis  N 10.00 

*  Jones,  Mrs.  J.  Edwin      ....  1.00 

Joslin,  Dr.  and  Mrs.  Elliott  P.  5.00 

Joy,  Mrs.  C.  H 1.00 

K.  P Sl.OO 

Kaffenburgh,  Mr  and  Mrs.  Isaac  7.00 

*Keeler,  Mrs.  L.  M 20.00 

Kehew,  Mrs.  Mary  Morton    .    .  10.00 

*Keith,  B.  F 5.00 

*Kennard,  Mrs.  C.  A 10.00 

Kennard,  Mrs.  C.  W 1.00 

Kennedy,  Mrs.  E.  L 1.00 

Kennedy,  Dr.  and  Mrs.  Harris.  10.00 

Kepler,  Charles  Ober,  M.D.  .    .  1.00 

*Kidder,  Mrs.  A.  M 25.00 

Kidder,  Mrs.  Henry  P 11.00 

Kidner,  Rev.  R 1.00 

Kimball,  David  P 100.00 

Kimball,  Mrs.  Franklin  R.     .    .  1.00 

*Kimball,  Mss  H.  H 20.00 

Kimball,  Miss  H.  P 1.00 

*K.  H.  T 10.00 

Kimball,  the  Misses 100.00 

Knight,  F.  1.,  M.D 1.00 

Knight,  Harry  W 1.00 

Knight,  J.  M 1.00 

Kohan,  Alexander,  M.D.    .    .    .  I'.OO 

*Kuhii,  Mrs.  H 20.00 

Ladd,  Babson  S $20.00 

Lamb,  H.  A 50.00 

*Lamb,  Mrs.  H.  A 25.00 

Lamb,  Miss  Rose 1.00 

♦Lancaster,  W.  B 3.00 

*Langley,  S.  S 5.00 

Lavalle,  Mrs $1.00 

Lawrence,  Rosewell  B 5.00 

Lawrence,  Mrs.  R.  M 5.00 

Lawrence,  Mrs.  William     .    .    .  2.00 


*Lawrence,  Miss  Sarah    ....  S5.00 

Lawrie,  Mrs.  William     ....  2.00 

Laxton.  John  W.  R.,  M.D.   .    .  26.00 

Lee,  Ellen  M I.OO 

Lee,  F.  W 1.00 

*Lee,  Mrs.  George  C 10.00 

Lee,  George  C 10.00 

Lee,  Mrs.  Henry 25.00 

Lee,  Mrs.  John  R 5.00 

*Lee,  Mrs.  James  S 10.00 

Lee,  Joseph      10.00 

Leen,  T.  F.,  M.D 1.00 

Lefavour,  Henry l.QO 

Leonard,  John l.QO 

Levey,  Mrs.  William  M.     .    .    .  1.00 

Lewis,  Miss  Harriet  G l.QO 

Liebmann,  Joseph  H 2.00 

*Lilly,  Mrs.  C banning 5.00 

Lincoln,  A.  L 2.00 

Lincoln,  Mrs.  Alice  N 25.00 

Linzee,  Miss 1.00 

Livermore,  Miss  Nellie  B.      .    .  5.00 

Locke,  Edwin  Allen,  M.D.     .    .  2.00 

*Lodge,  Mrs.  H.  C 10.00 

Lombard,  M.  Elizabeth      .    .    .  1.00 

Long,  Harry  V 5.00 

Longfellow,  Miss  A.  M 1.00 

Longfellow,  A.  W 3.00 

Lootz,  Mrs.  Selma 2.00 

Lord,  Frederick  T.,  M.D.  .    .    .  1.00 

Lord,  Mary  B 1.00 

Loring,  Augustus  P 45.00 

Loring,  Mrs.  A.  P 5.00 

Loring,  Miss  Louise  P 1.00 

Loring,  Miss  M.  P 6.00 

Lothrop,  Mrs.  T.  K 20.00 

Lowell,  Francis  C 20.00 

*Lowell,  Frederick  E 10.00 

Lowell,  Mrs.  George  G 10.00 

Lowell,  Miss  Georgina    ....  6.00 

Lowell,  Miss  Lucy 12.00 

*Lyman,  Mrs.  Arthur 55.00 

*Lyman,  F. 10.00 

*Lyman,  Mrs.  George  H.     .    .    .  10.00 

Lyman,  Miss  Julia 45.00 

*Lyman,  Miss  Mabel 5.00 

*Lyman,  Mrs.  Theodore  ....  50.00 

iVlacDonald,  HenryP.     .    .    .  $1.00 

McClure,  M.  M 5.00 

McCleary,  Miss  Cornelia  W.  .    .  1.00 

McKey,  Joseph 3.00 

McNab,  Miss  Ada 1.00 

Mack,  Mrs.  Thomas 1.00 

Mackey,  J.  P 5.00 

Madden,  M.  L 10.00 

Mallory,  F.  B.,  M.D 1.00 

Mann,  William  O.,  M.D.    .    .    .  1.00 

Marion,  Horace  E.,  M.D.  .    .    .  1.00 

Mason,  Miss  E.  F 1.00 

Mason.  Miss  Ida      60.00 

*May,  Miss  Eleanor  G 5.00 

Means,  Anne  M 5.00 


41 


♦Merriam,  Arthur  M S  5.00 

♦Merriam,  Mrs.  F 10.00 

Merriam,  Miss  Mary  L 1.00 

Merrill,  A.  A 1.00 

Merrill,  Miss  F.  E 10.00 

Meniman,  Mrs.  Daniel  ....  10.00 

Metcalf,  Mrs.  Theodore      .    .    .  1.00 

*Meyer,  Mies  Heloise 5.00 

Miles,  C.  Edwin,  M.D.        .    .    .  3.00 

Miller,  Hugh 5.00 

Minot,  Harriet  J 10.00 

Minot,  Mr.  and  Mrs.  J.  G..    .    .  2.00 

Minot,  James  J.,  M.D 126.00 

Minot,  Lawrence 10.00 

Minot,  Miss  Mary 5.00 

*Mibot,  The  Misses 10.00 

Mixter,  Miss  M.  C 6.00 

Monks,  Mrs.  G.  H 10.00 

Moore,  Miss  M.  S 4.00 

Morison,  George  B 5.00 

*Morrill,  Miss  Amelia 10.00 

*Morrill,  Miss  Anne  W 10.00 

*MorrilI,  Miss  Fanny  E 10.00 

Morris,  John  G.,  M.D 1.00 

Morse,  C.  Willis 2.00 

*Morse,  Miss  E.  C 5.00 

Morse,  Miss  Ellen  C 2.00 

Morse,  E.  G.,  M.D 1.00 

Morse,  Mr.  and  Mrs.  F.  A.     .    .  2.00 

Morse,  Miss  Frances  E..      ...  16.00 

Morse,  Henry  L.,  M.D 5.00 

*Morse,  Mrs.  Robert  M.  .    .    .    .  10.00 

*Morse,  Mrs.  Samuel  T 15.00 

*Morse,  Mary  E 5.00 

Morton,  Miss  Helen 4.00 

Morville,  R.  W.,  Jr 5.00 

*Moseley,  F.  S.  &  Co 10.00 

Mossman,  W.  B 10.00 

Motley,  Mrs.  E.  P 25.00 

*Motley.  Mrs.  Thomas,  Jr.  .    .    .  5.00 

Mumford,  James  G.,  M.D.     .    .  1.00 

Murdook,  The  Misses      ....  2.00 

Murphy,  Mrs.  Frank  S.      ...  1.00 

Murphy,  Fred  T 1.00 

Murphy,  James  R 1.00 

"Nahant" SIO.OO 

Nash,  Frank  K 1.00 

Neilson,  Emma  C 5.00 

Newell,  Mrs.  James  M 6.00 

*Newell,  F.  S 10.00 

Newell,  Mary  A.  M 5.00 

Newman,  Leon,  M.D 1.00 

Nichols,  Mrs.  J.  Howard    .    .    .  2.00 

Nichols,  Mrs.  W.  R 1.00 

Nickerson,  Andrew 11.00 

*Norcross,  Mrs.  Otis 25.00 

Norcross,  Mrs.  Otis,  Jr 6.00 

Norman,  Mrs.  Guy 20.00 

Noyes,  Susan  P 1.00 

*New  Eng.  Tel.  &  Telegraph  Co.  15.00 

♦O'Brien,  John  F S5.00 

Oliver,  Mrs.  S.  Parkman    .    .    .  6.00 


Osborne,  George  A $1.00 

Osgood.  Dr.  Hamilton   ....  5.00 

♦Osgood.  Mrs.  J.  F 10.00 

Otis,  Mrs.  H.  F 10.00 

*Otis,  Margaret  S 10.00 

Otis,  Mrs.  William  C 20.00 

Page,  Calvin  G.,  M.D 81.00 

Paine,  Ethel  L 5.00 

Paine,  Rev.  George  L 5.00 

Paine,  Robert  Treat 10.00 

Paine,  Robert  T.,  Jr 45.00 

*Paine,  Misses  S.  C.  and  M.    .    .  10.00 

Paine,  Sarah  C 5.00 

*Palfrey,  Mrs.  John  C 5.00 

Pankman,  Miss  M.  R 6.00 

Parker,  Miss  C.  V 1.00 

Parker,  Miss  Eleanor  S.     .    .    .  5.00 

Parker,  W.  Prentiss 1.00 

Payne,  Mrs.  John  H 1.00 

Payson,  S.  C 1.00 

♦Peabody,  Mrs.  F.  H 3.00 

Peabody,  Miss  G.  W 6.00 

Peabody,  Miss  L.  M 1.00 

Peabody,  Mrs.  R.  S 11.00 

Peabody,  Mrs.  S.  E 15.00 

Peirce,  Charlotte 2.00 

Peirce,  George 1.00 

Penhallow,  Mrs.  D.  P 5.00 

Perry,  Mrs.  Annie  Moseley    .    .  1.00 

Perry,  Arthur 5.00 

Perry,  G.  W 6.00 

Pfaelzer,  Franklin  T 5.00 

Philbrick.  Mrs.  Edward  S.     .    .  2.00 

Phillips,  A.  V 3.00 

Phillips,  Mrs.  J.  C 60.00 

Pickering,  Mr.  and  Mrs.  H.   .    .  100.00 

Pickman,  Mrs.  D.  L 50.00 

Piehler,  Otto  J 15.00 

Pierce,  Miss  K.  C 6.00 

Pierce,  Wallace  L 110.00 

Pitman,  Mrs.  B.  F 3.00 

Pope,  C.  Augusta,  M.D.     .    .    .  3.00 

Pope,  Emily  F.,  M.D 3.00 

Pope,  Mrs.  W.  C 2.00 

Porter,  Alexander  S 11.00 

Porter,  C.  B.,  M.  D 1.00 

Porter,  Mr.  and  Mrs.  G.  M.   .    .  2.00 

Post,  Abner,  M.D 1.00 

Potter,  Mrs.  Murray  A.      ...  1.00 

Potter,  William  H 6.00 

Pratt,  J.  H.,  M.D 1.00 

Pratt,  R.  M 50.00 

Prendergast,  James  M 10.00 

Prendergast,  Miss  Julia  C.     .    .  5.00 

Prescott,  Oliver,  Jr 1.00 

Prescott,  W.  H.,  M.D 1.00 

Prince,  Mrs.  C.  J 1.00 

Prior,  Mrs.  Isabelle  A 1.00 

Proctor,  Miss  Mary  B 1.00 

Proctor,  Redfield,  Jr 11.00 

Punchard,  Miss  A.  L 6.00 

Putnam,  Mrs.  George     ....  6.00 


42 


Putnam,  Miss  Georgina  Lowell  So. 00 

Putnam,  Mrs.  W.  L 21.00 

Rackennan,  Mrs.  Felix     .    .    .  $6.00 

Rand,  A.  A 10.00 

Ratchesky,  A.  C 5.00 

Raymond,  Mrs.  H.  E 2.00 

Read,  Sarah  E 5.00 

Reed,  Arthur 3.00 

*Reed,  Ida  Bartlett      10.00 

Reynolds,  The  Misses     ....  2.00 

Rice,  Cora  L 3.00 

Rice,  H.  L 1.00 

Rice,  Mrs.  Wilbur  P 2.00 

Richards,  Miss  A.  A 5.00 

Richardson,  Miss  Elizabeth  M.  1.00 

Richardson,  Mrs 250.00 

Rines,  R.  Hight       1.00 

Ripley,  F.  H 1.00 

*Ripley,  George 10.00 

*Robbins,  Miss  Agnes  F.      .    .    .  25.00 

*Robbins,  Mary  E 3.50 

Roberts,  Rev.  W.  Dewees.    .    .  1.00 

Robey,  Dr.  and  Mrs.  W.  H.,  Jr.  5.00 

Robinson,  J.  C 5.00 

Rockwell,  Miss  Maud  M.    .    .    .  1.00 

Rodman,  Miss  Emma     ....  1 5.00 

Rogers,  Miss  Annette  P.    .    .    .  25.00 

♦Rogers,  Miss  Frances  S.     .    .    .  2.00 

♦Rogers,  Miss  Laura  D 2.00 

Rogers,  Mrs.  W.  B 5.00 

Rooney,  Miss  Anna  A 2.00 

*Ropes,  Mary  M 5.00 

Ross,  Mrs.  Waldo  0 10.00 

Rowe,  G.  H.  M.,  M.D 1.00 

*Rowley,  Rev.  Francis  H.  .    .    .  3.00 

Ruggles.  Daniel  B 4.00 

Russell,  Mrs.  H.  S 1.00 

♦Russell,  Mrs.  Richard  S.    .    .    .  15.00 

♦Russell,  Mrs.  Robert  S.      .    .    .  100.00 

Rutan,  Charles  H 5.00 

Ryder,  J.  W.,  M.D 1.00 

*S.,  E.  A Sl.OO 

Sabine,  G.  K.,  M.D 1.00 

Saltonstall,  Mrs.  P.  L 6.00 

Saltonstall,  Mrs.  R.  M 25.00 

♦Sampson,  Eugenia 2.00 

Sanborn,  Caroline  F 2.00 

Sanborn,  Mrs.  Florence  A.     .    .  5^.00 

Sanders,  OrrenB.,  M.D.    .    .    .  1.00 

♦Sargent,  Mrs.  S.  A 5.00 

Savage,  Catherine  D 1.00 

Schlesinger,  Mrs.  Mary  ....  11.00 

Schmidt,  Arthur  P 11.00 

Scripture,  Miss  Bertha   ....  1.00 

Scull,  Mrs.  G 20.00 

Sears,  Francis  P 10.00 

Sears,  Frederick  R 10.00 

Sears,  Mrs.  F.  R 10.00 

Sears,  George  G 1.00 

♦Sears,  Mrs.  K.  W 25.00 


Sears,  Mrs.  P.  H Sl.OO 

♦Sears,  Mrs.  Richard  D 25.00 

Sever,  Emily 1.00 

Shapleigh,  J.  H 1.00 

Sharp,  Virginia  G 1.00 

Shattuck,  F.  C,  M.D 5.00 

Shattuck,  George  B.,  M.D.    .    .  1.00 

Shattuck,  Miss  Miriam  S.  .    .    .  5.00 

Shaw,  Mrs.  B.  S 6.00 

Shaw,  Francis 5.00 

Shaw,  Mrs.  G.  H 75.00 

Shaw,  George  R 1.00 

Shaw,  Henry  L.,  M.D 1.00 

Shaw,  Q.  A.,  Jr 25.00 

Shaw,  Mrs.  R.  G 35.00 

Shaw,  S 10.00 

Sheebe,  Miss  Katherine  H.    .    .  1.00 

Shepard,  Miss  Emily  B.     .    .    .  10.00 

Shepard,  Mrs.  Otis 10.00 

Shepard,  T.  H 5.00 

Sherwin,  Thomas 10.00 

♦Shurtleg,  Asahel  M 5.00 

♦Shute,  Katherine  H 2.50 

Skinner,  Francis 15.00 

Slade,  Mrs.  D.  D 21.00 

Slocum,  William  H 5.00 

Smith,  Miss  Ellen  \ 50.00 

Smith,  Mrs.  J.  N 6.00 

Smith,  Theobald,  M.D 1.00 

Smithwick,  M.  P.,  M.D.     .    .    .  1.00 

Sohier,  Miss  Elizabeth  D.       .    .  6.00 

Sohier,  Miss  Emily  L 10.00 

Souther,  Mrs.  J.  K 1.00 

♦Sowdon,  A.  J.  C 10.00 

Spaulding,  Mrs.  Mahlon  D.    .    .  26.00 

Spaulding,  William  S 150.00 

Spillane.  Mary  E 1.00 

Sprague,  F.  P.,  M.D 10.00 

Sprague,  Mrs.  S.  E 1.00 

Stackpole,  F.  D 6.00 

Stackpole,  Miss  Roxana     .    .    .  1.00 

Staigg,  Mrs.  R.  M 7.00 

Stanwood,  Edward 6.00 

Stedman.  Henry  R.,  M.D.     .    .  3.00 

Stedman,  Joseph,  M.D.      .    .    .  1.00 

Stephenson,  Miss  S.  L 3.00 

Stevenson,  Misses 5.00 

Stevenson,  Mrs.  Robert  H.    .    .  10.00 

Stone,  Mrs.  Edwin  P 5.00 

♦Stone,  Mr.  and  Mrs.  Frederic    .  15.00 

♦Stone,  Mark 1.00 

Stone,  Nathaniel  H 11.00 

Stone,  Mrs.  P.  S 1.00 

Storrow,  Charles 5.00 

Storrow,  Miss  E.  R 11.00 

Storrow,  Mrs.  J.  J 10.00 

Strater,  Francis  A 1.00 

♦Sturgis,  Charles  R 5.00 

♦Sturgis,  Mrs.  H.  P 5.00 

Sturgis,  Robert  S 1.00 

SulUvan,  John  J.,  M.D.      .    .    .  1.00 

Sweetser,  Mrs.  F.  L 2.00 

Swift,  Walter,  M.D 1.00 


43 


Taft,  Albert,  M.D $1.00 

Tainter,  Mrs.  Charles  Wilson    .  5.00 

Talbot,  Miss  M.  Eloise   ....  1.00 

Talbot,  Mrs.  Thomas      ....  46.00 

♦Tapley,  Miss  Alice  P 25.00 

Tapley,  Mrs.  Amos  P 31.00 

Tapper,  Mrs.  T 5.00 

*Teele,  J.  Mede 5.00 

Thacher,  Elizabeth  B 5.00 

Thacher,  Mrs.  H.  C 5.00 

Thacher,  Miss  S.  C 5.00 

♦Thacher,  Mrs.  T.  C 5.00 

Thayer,  Mrs.  Ezra  Ripley      .    .  10.00 

Thayer,  Mrs 5.00 

*Thayer,  Mrs.  Nathaniel      .    .    .  25.00 

Thayer,  Mrs.  W.  G 10.00 

Thompson,  Charles  0 5.00 

Thorndike,  Augustus,  M.D.  .    .  5.00 

Tileston,  Mrs.  and  Miss      .    .    .  2.00 

Tower,  Miss  Ellen  M 20.00 

Townsend,  D.,  M.D 1.00 

Townsend,  Mrs.  William  S.   .    .  5.00 

Trule,  Miss  M.  R 1.00 

Tuckerman,  Mrs.  C.  S 10.00 

Tuckerman,  Mr.  and  Mrs.  L.  S.  12.00 

♦Turner,  A.  N 20.00 

♦Turner,  B.  S 10.00 

Tuxbury,  Miss  Cora 1.00 

Tyler,  George  A 6.00 

Underwood,  H.  O SIO.OO 

Upham,  Miss  E.  Annie  ....  1.00 

Vickery,  Herman  F.,  M.D.  SI. 00 

Vose,  Robert  C 2.00 

Vorenberg,  Simon 1.00 

Wadleigh,  Caroline  E.     .    .    .  Sl.OO 

Wadsworth,  D.  F 1.00 

♦Wainwright,  Miss  S.  H 6.00 

Walker,  Charles  C 11.00 

Walker,  E.  S 5.00 

Ward,  Miss  A.  S 1.00 

Ward,  Miss  Ellen  M 6.00 

Wards,  Miss  Sarah  E 2.00 

Ware,  Charles  P 3.43 

Warren,  Bentley  W 5.00 

Warren,  Henry  E 1.00 

Warren,  J.  Collins,  M.D.    .    .    .  5.00 

Waters,  Mrs.  Clement     ....  5.00 

Watson,  Mrs.  R.  C 10.00 

Watson,  William 1.00 

Watts,  H.  F.  R.,  M.D 1.00 

Waxman,  Mrs.  N 1.00 

Way-Allen,  Eleanor,  M.D.     .    .  21.00 


Webster,  A.  S $5.00 

Webster,  F.  G 151.00 

Webster,  Marianne  W 3.00 

Weld,  Mrs.  A.  Davis 5.00 

♦Weld,  B.  C 5.00 

♦Weld,  Mrs.  William  F 20.00 

Wells,  David  W.,  M.D 1.00 

Wentworth,  Mrs.  Charles  F.      .  3.00 

♦Wesson,  Mrs.  Frank  L 50.00 

Wesson,  Mrs.  J.  L 1.00 

West,  Mrs.  Preston 5.00 

♦Weston,  Mrs.  Henry  C.      ...  25.00 

Wharton,  Mrs.  Susan 6.00 

♦Wheeler,  H.  C 5.00 

Wheelwright,  Charles  C.    .    .    .  10.00 

Wheelwright,  Mrs.  George  W.  .  6.00 

Wheelwright,  Miss  Josephine  M.  1.00 

Wheelwright,  J.  W 10.00 

♦Whipple,  Mrs.  E.  A 5.00 

White,  Dr.  and  Mrs.  Charles  T.  7.00 

White,  Miss  Gertrude  R.   .    .    .  3.00 

White,  Henrietta  H 10.00 

White,  James  C,  M.D 1.00 

White,  Walter  H.,  M.D.     .    .    .  5.00 

Whiteside,  Mrs.  A. 1.00 

Whiting,  Anna  M 2.00 

Whitmore,  William 50.00 

Whitmore,  Albion  S 5.00 

Whitney,  Miss  A 4.00 

♦Whitney,  Ellen  S 5.00 

Whitney,  Miss  Kate  A.      ...  1.00 

Whit  well,  Frederick  A 1.00 

Whitwell,  Miss  N.  S 5.00 

Wigglesworth,  Mrs.  E 5.00 

Wigglesworth,  George    ....  70.00 

Williams.  John  D 10.00 

Williams,  Susan  J 10.00 

♦Wilson,  Lilly  M 15.00 

Winkley,  Mrs.  S.  H 6.00 

Winslow,  C.  G 2.00 

Winsor,  Mrs.  Henry 10.00 

Winsor,  Miss  Mary  P 1.00 

Winthrop,  Mrs.  R.  C,  Jr.      .    .  26.00 

Withington,  Charles  F.,  M.D.    .  1.00 

Wolcott,  Grace,  M.D 1.00 

Wolcott,  Mrs.  Roger 5.00 

Wood,  Nelson  M 5.00 

Woodman,  Stephen  F 1.00 

♦Woods,  Mrs.  Henry 75.00 

Woods,  Robert  A .  1.00 

Woodworth,  Mrs.  Alfred  P.  .    .  5.00 

Wright,  George  H 6.00 

♦Wright  &  Potter 5.00 

Wyzanski,  Max  E 1.00 

♦Young.  Mr.  and  Mrs.  B.  L. .     .  $20.00 


44 


J 


OBJECTS 

The  objects  of  this  Association  are  to  promote  a  careful 
study  of  conditions  regarding  tuberculosis  in  Boston;  to  educate 
pubhc  opinion  as  to  the  causes  and  prevention  of  tuberculosis; 
and  to  arouse  general  interest  in  securing  adequate  provision 
for  the  proper  care  of  tuberculous  patients  in  their  homes  and 
by  means  of  hospitals  and  sanatoria. 

FORM  OF  BEQUEST 

/  give  and  bequeath  unto  the  Boston  Association  for 
the  Relief  and  Control  of  Tuberculosis,  incorporated  under 
the  laws  of  the  Commonwealth  of  Massachusetts  in  the 
year  1905,  its  successors  and  assigns,  the  sum  of 


We  send  this  report  to  you  with  the  belief  that  it  will  claim 
your  interest  and  attention,  and  in  the  hope  that  after  reading 
it  you  will  become  a  member,  if  not  one  already,  and  give 
whatever  additional  support  you  are  able.  The  Association 
is  supported  entirely  by  voluntary  contributions.  It  is  now 
entering  upon  its  fifth  year  of  active  work. 

This  blank  may  be  sent  to 


George  S.  Mumford,  Treasurer,  50  State  Street,  Boston. 

I  enclose  $1.00,  MEMBERSHIP  FEE,  for  the  year  ending 
October  31,  1908,  and  $  for  promotion  of  the  work. 


Name 

Address 

Please  give  P.O.  address  for  return  of  receipt. 


I 


1 


^  A    stage    of  civilization    is    marked    b^ 
rejection    of   the    divine    origin    of  disc? 
doctrine  and  by  attributing  death  from  ^^te 
ventable  disease  to  a  failure  of  governmenu 


"Are  you  in  the  habit  of  estimating  the 
happiness  and  misery  of  your  community  by 
the  decrease  or  increase  in    its  death   rate 

from     preventable     causes?" — Efficient  Democracy. 


LOOK  FROM  THIS  POINT  OF  VIEW : 

^  Doctors  and   Health  officers   should 
retained     to    exercise    eternal    vigilance 
preserving   the   health    that   is    natural  af 
be   active   in    avoiding    danger  rather    tha 
in  encountering  it.      The  ways  of  avoiding 
sickness    are    positive    and    clear,    those    of 
overcoming    it    are    devious    and   elusive. 


OHIFFITH  -STILLtHOS  » 
MS  CO>«aftEa8*T.,  f 


